Basic Information
| Provider Information | |||||||||
| NPI: | 1386773745 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HUPRICH | ||||||||
| FirstName: | STEVEN | ||||||||
| MiddleName: | K | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | PHD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7457 FRANKLIN RD | ||||||||
| Address2: | SUITE 210 | ||||||||
| City: | BLOOMFIELD HILLS | ||||||||
| State: | MI | ||||||||
| PostalCode: | 483013611 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2488072159 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 7457 FRANKLIN RD | ||||||||
| Address2: | SUITE 210 | ||||||||
| City: | BLOOMFIELD HILLS | ||||||||
| State: | MI | ||||||||
| PostalCode: | 483013611 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2488072159 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/03/2007 | ||||||||
| LastUpdateDate: | 03/28/2016 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103TC0700X | 6301012640 | MI | Y | Behavioral Health & Social Service Providers | Psychologist | Clinical |
ID Information
| ID | Type | State | Issuer | Description | 680D710830 | 01 | MI | BCBS PIN | OTHER |