Provider Demographics
NPI:1528541984
Name:UNDERCURRENT BEHAVIORAL HEALTH LLC
Entity Type:Organization
Organization Name:UNDERCURRENT BEHAVIORAL HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:J
Authorized Official - Last Name:WEBLER
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW
Authorized Official - Phone:586-443-1811
Mailing Address - Street 1:30720 LUND AVE
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:MI
Mailing Address - Zip Code:48093-8019
Mailing Address - Country:US
Mailing Address - Phone:586-443-1811
Mailing Address - Fax:
Practice Address - Street 1:12500 E 13 MILE RD
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:MI
Practice Address - Zip Code:48093-5011
Practice Address - Country:US
Practice Address - Phone:586-913-1623
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-12
Last Update Date:2018-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty