Provider Demographics
NPI:1750839783
Name:ACE PSYCHOLOGICAL CONSULTANTS LLC
Entity Type:Organization
Organization Name:ACE PSYCHOLOGICAL CONSULTANTS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:AUSTIN
Authorized Official - Middle Name:
Authorized Official - Last Name:YUNCK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-632-1600
Mailing Address - Street 1:1920 LIVERNOIS RD STE D
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48083-1770
Mailing Address - Country:US
Mailing Address - Phone:248-632-1600
Mailing Address - Fax:
Practice Address - Street 1:1920 LIVERNOIS RD STE D
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:MI
Practice Address - Zip Code:48083-1770
Practice Address - Country:US
Practice Address - Phone:248-632-1600
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-20
Last Update Date:2016-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301016394103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103G00000XBehavioral Health & Social Service ProvidersClinical NeuropsychologistGroup - Single Specialty