Provider Demographics
NPI:1760184576
Name:OAKLAND PSYCHOLOGICAL CENTER, PLLC
Entity Type:Organization
Organization Name:OAKLAND PSYCHOLOGICAL CENTER, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST/OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHAVON
Authorized Official - Middle Name:ROSE
Authorized Official - Last Name:ROMITA
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:586-214-7766
Mailing Address - Street 1:691 N SQUIRREL ROAD SUITE LL 125
Mailing Address - Street 2:
Mailing Address - City:AUBURN HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48309
Mailing Address - Country:US
Mailing Address - Phone:586-214-7766
Mailing Address - Fax:
Practice Address - Street 1:691 N SQUIRREL ROAD SUITE LL 125
Practice Address - Street 2:
Practice Address - City:AUBURN HILLS
Practice Address - State:MI
Practice Address - Zip Code:48309
Practice Address - Country:US
Practice Address - Phone:586-214-7766
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-17
Last Update Date:2023-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty