Provider Demographics
NPI:1891906061
Name:NEUROBEHAVIORAL CONSULTANTS, P.C.
Entity Type:Organization
Organization Name:NEUROBEHAVIORAL CONSULTANTS, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TREASURER
Authorized Official - Prefix:MS
Authorized Official - First Name:JOAN
Authorized Official - Middle Name:MARY
Authorized Official - Last Name:INWALD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-723-9200
Mailing Address - Street 1:31600 TELEGRAPH RD STE 230
Mailing Address - Street 2:
Mailing Address - City:BINGHAM FARMS
Mailing Address - State:MI
Mailing Address - Zip Code:48025-4372
Mailing Address - Country:US
Mailing Address - Phone:248-723-9200
Mailing Address - Fax:248-723-9218
Practice Address - Street 1:31600 TELEGRAPH RD STE 230
Practice Address - Street 2:
Practice Address - City:BINGHAM FARMS
Practice Address - State:MI
Practice Address - Zip Code:48025-4372
Practice Address - Country:US
Practice Address - Phone:248-723-9200
Practice Address - Fax:248-723-9218
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIJI007220103G00000X, 103TB0200X, 103TC2200X, 103TF0200X, 103TP2701X, 103TR0400X
MIJI007200103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered103G00000XBehavioral Health & Social Service ProvidersClinical NeuropsychologistGroup - Multi-Specialty
Not Answered103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & BehavioralGroup - Multi-Specialty
Not Answered103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
Not Answered103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & AdolescentGroup - Multi-Specialty
Not Answered103TF0200XBehavioral Health & Social Service ProvidersPsychologistForensicGroup - Multi-Specialty
Not Answered103TP2701XBehavioral Health & Social Service ProvidersPsychologistGroup PsychotherapyGroup - Multi-Specialty
Not Answered103TR0400XBehavioral Health & Social Service ProvidersPsychologistRehabilitationGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIOF33125OtherBLUE CROSS
MIOF33125OtherBLUE CROSS
MIR66855Medicare UPIN