Provider Demographics
NPI:1689094005
Name:PASICK CONSULTATION AND COACHING LLC
Entity Type:Organization
Organization Name:PASICK CONSULTATION AND COACHING LLC
Other - Org Name:ROBERT PASICK PHD
Other - Org Type:Other Name
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:S
Authorized Official - Last Name:PASICK
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:734-730-1765
Mailing Address - Street 1:2723 S STATE ST
Mailing Address - Street 2:SUITE 150
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48104-6188
Mailing Address - Country:US
Mailing Address - Phone:734-730-1765
Mailing Address - Fax:
Practice Address - Street 1:2723 S STATE ST
Practice Address - Street 2:SUITE 150
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48104-6188
Practice Address - Country:US
Practice Address - Phone:734-730-1765
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-24
Last Update Date:2014-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty