Provider Demographics
NPI:1639390065
Name:THE HEARING CENTER
Entity Type:Organization
Organization Name:THE HEARING CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUDIOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:STACEY
Authorized Official - Middle Name:MICHELLE
Authorized Official - Last Name:SIMON
Authorized Official - Suffix:
Authorized Official - Credentials:MS, CCC-A
Authorized Official - Phone:248-926-1586
Mailing Address - Street 1:7577 WINDGATE CIR
Mailing Address - Street 2:
Mailing Address - City:WEST BLOOMFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48323-3911
Mailing Address - Country:US
Mailing Address - Phone:248-926-1586
Mailing Address - Fax:248-926-1586
Practice Address - Street 1:27301 SCHOENHERR RD
Practice Address - Street 2:SUITE 105
Practice Address - City:WARREN
Practice Address - State:MI
Practice Address - Zip Code:48088-6649
Practice Address - Country:US
Practice Address - Phone:586-756-4009
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI1601000169237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid FitterGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIP25966FOtherBCN