1750430377 NPI number — JOEL R HARMS PHD AND DEBORAH G HARMS PHD PC

Table of content: (NPI 1750430377)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1750430377 NPI number — JOEL R HARMS PHD AND DEBORAH G HARMS PHD PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
JOEL R HARMS PHD AND DEBORAH G HARMS PHD PC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1750430377
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
21783 CORSAUT LN
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BEVERLY HILLS
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
48025-2607
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
248-258-5593
Provider Business Mailing Address Fax Number:
248-540-2494

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
31815 SOUTHFIELD RD
Provider Second Line Business Practice Location Address:
STE 31
Provider Business Practice Location Address City Name:
BEVERLY HILLS
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48025-5471
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
248-258-5593
Provider Business Practice Location Address Fax Number:
248-540-2494
Provider Enumeration Date:
01/10/2007

Additional Information

Authorized Official

Authorized Official Last Name:
HARMS
Authorized Official First Name:
JOEL
Authorized Official Middle Name:
R
Authorized Official Title or Position:
LICENSED PSYCHOLOGIST PRESIDENT
Authorized Official Telephone Number:
248-258-5593

Provider Taxonomy Codes

  • Taxonomy code: 103T00000X , with the licence number:  6301003815 , registered in the state of MI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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