Provider Demographics
NPI:1336833615
Name:DEMSHUR THERAPY SERVICES PLLC
Entity Type:Organization
Organization Name:DEMSHUR THERAPY SERVICES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST/OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:SALLY
Authorized Official - Middle Name:CATHERINE
Authorized Official - Last Name:DEMSHUR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-260-8612
Mailing Address - Street 1:4295 OKEMOS RD STE 160
Mailing Address - Street 2:
Mailing Address - City:OKEMOS
Mailing Address - State:MI
Mailing Address - Zip Code:48864-6200
Mailing Address - Country:US
Mailing Address - Phone:919-260-8612
Mailing Address - Fax:
Practice Address - Street 1:4295 OKEMOS RD STE 160
Practice Address - Street 2:
Practice Address - City:OKEMOS
Practice Address - State:MI
Practice Address - Zip Code:48864-6200
Practice Address - Country:US
Practice Address - Phone:616-765-8720
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-08
Last Update Date:2023-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty