Provider Demographics
NPI:1639123706
Name:ALSTERBERG, CARL ERIC (PHD)
Entity Type:Individual
Prefix:DR
First Name:CARL
Middle Name:ERIC
Last Name:ALSTERBERG
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:52759 WOODMILL DR
Mailing Address - Street 2:
Mailing Address - City:MACOMB
Mailing Address - State:MI
Mailing Address - Zip Code:48042-5668
Mailing Address - Country:US
Mailing Address - Phone:586-677-7860
Mailing Address - Fax:586-677-7860
Practice Address - Street 1:52759 WOODMILL DR
Practice Address - Street 2:
Practice Address - City:MACOMB
Practice Address - State:MI
Practice Address - Zip Code:48042-5668
Practice Address - Country:US
Practice Address - Phone:586-677-7860
Practice Address - Fax:586-677-7860
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301002887103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical