Provider Demographics
NPI:1619959400
Name:DOHRENWEND, ANNE MARIE (PHD)
Entity Type:Individual
Prefix:MS
First Name:ANNE
Middle Name:MARIE
Last Name:DOHRENWEND
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:904 SPRING ST
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48103-3243
Mailing Address - Country:US
Mailing Address - Phone:734-657-9034
Mailing Address - Fax:810-342-1590
Practice Address - Street 1:202 E WASHINGTON ST STE 606
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48104-2012
Practice Address - Country:US
Practice Address - Phone:734-657-9033
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-17
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301010100103TC0700X, 103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
056350OtherVQLUE OPTIONS
MI0985309OtherHEALTH PLUS
MI253151OtherHEALTH ADVANTAGE NETWORK
MI253151OtherMCLAREN HEALTH PLAN
1962541318OtherMCLAREN GROUP NPI #
MI680B512650OtherBCBSM-BCN-FEP
MI0M04830005Medicare PIN
MI0985309OtherHEALTH PLUS