Provider Demographics
NPI:1861636110
Name:WARTEL BEHAVIORAL SERVICES, P.C.
Entity Type:Organization
Organization Name:WARTEL BEHAVIORAL SERVICES, P.C.
Other - Org Name:WARTEL PSYCHOLOGICAL SERVICES
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:JACOB
Authorized Official - Last Name:WARTEL
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:248-626-1330
Mailing Address - Street 1:6346 ORCHARD LAKE RD
Mailing Address - Street 2:SUITE 107
Mailing Address - City:WEST BLOOMFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48322-2326
Mailing Address - Country:US
Mailing Address - Phone:248-626-1330
Mailing Address - Fax:248-626-9170
Practice Address - Street 1:6346 ORCHARD LAKE RD
Practice Address - Street 2:SUITE 107
Practice Address - City:WEST BLOOMFIELD
Practice Address - State:MI
Practice Address - Zip Code:48322-2326
Practice Address - Country:US
Practice Address - Phone:248-626-1330
Practice Address - Fax:248-626-1330
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-29
Last Update Date:2013-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty