Provider Demographics
NPI:1952967317
Name:SHARI SLEBODNIK, PHD
Entity Type:Organization
Organization Name:SHARI SLEBODNIK, PHD
Other - Org Name:SHARI SLEBODNIK, PHD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO/CLINICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:SHARI
Authorized Official - Middle Name:
Authorized Official - Last Name:SLEBODNIK
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, LLP
Authorized Official - Phone:586-838-0825
Mailing Address - Street 1:24674 BERRY AVE
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:MI
Mailing Address - Zip Code:48089-2132
Mailing Address - Country:US
Mailing Address - Phone:586-838-0825
Mailing Address - Fax:248-809-4134
Practice Address - Street 1:1700 W BIG BEAVER RD STE 200
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:MI
Practice Address - Zip Code:48084-3524
Practice Address - Country:US
Practice Address - Phone:586-838-0825
Practice Address - Fax:248-809-4134
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-11
Last Update Date:2020-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health