Basic Information
| Provider Information | |||||||||
| NPI: | 1962038695 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | STEVEN K HUPRICH PHD PLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 107 E MAIN ST STE 204 | ||||||||
| Address2: | |||||||||
| City: | NORTHVILLE | ||||||||
| State: | MI | ||||||||
| PostalCode: | 481671566 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2488072159 | ||||||||
| FaxNumber: | 7342075326 | ||||||||
| Practice Location | |||||||||
| Address1: | 107 E MAIN ST STE 204 | ||||||||
| Address2: | |||||||||
| City: | NORTHVILLE | ||||||||
| State: | MI | ||||||||
| PostalCode: | 481671566 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2488072159 | ||||||||
| FaxNumber: | 7342075326 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/13/2020 | ||||||||
| LastUpdateDate: | 03/13/2020 | ||||||||
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| AuthorizedOfficialLastName: | HUPRICH | ||||||||
| AuthorizedOfficialFirstName: | STEVEN | ||||||||
| AuthorizedOfficialMiddleName: | K | ||||||||
| AuthorizedOfficialTitleorPosition: | PHD / OWNER | ||||||||
| AuthorizedOfficialTelephone: | 2488072159 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | PHD - PSYD | ||||||||
| NPICertificationDate: | 03/13/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103TC0700X | Y | 193400000X SINGLE SPECIALTY GROUP | Behavioral Health & Social Service Providers | Psychologist | Clinical |
No ID Information.