Provider Demographics
NPI:1265870414
Name:FERSHTMAN, LINDA F (SPSYS, LLP)
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:F
Last Name:FERSHTMAN
Suffix:
Gender:F
Credentials:SPSYS, LLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2790 PARKWICK CT
Mailing Address - Street 2:SUITE 101
Mailing Address - City:WEST BLOOMFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48324-4105
Mailing Address - Country:US
Mailing Address - Phone:248-363-2850
Mailing Address - Fax:800-380-6809
Practice Address - Street 1:8898 COMMERCE RD
Practice Address - Street 2:SUITE 3A
Practice Address - City:COMMERCE TWP
Practice Address - State:MI
Practice Address - Zip Code:48382-4485
Practice Address - Country:US
Practice Address - Phone:248-363-2850
Practice Address - Fax:800-380-6809
Is Sole Proprietor?:No
Enumeration Date:2013-06-10
Last Update Date:2013-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301012935103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent