| Premier Behavioral Medicine, Pllc | |
|
20282 Middlebelt Rd Livonia MI 48152-2002 | |
| (248) 536-2028 | |
| (248) 536-2451 |
| Full Name | Premier Behavioral Medicine, Pllc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 20282 Middlebelt Rd, Livonia, Michigan |
| Authorized Official Name and Position | Masroor Ul Haq (PSYCHIATRIST) |
| Authorized Official Contact | 2487191256 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Premier Behavioral Medicine, Pllc 20282 Middlebelt Rd Livonia MI 48152-2002 Ph: (248) 536-2028 | Premier Behavioral Medicine, Pllc 20282 Middlebelt Rd Livonia MI 48152-2002 Ph: (248) 536-2028 |
| NPI Number | 1588038343 |
|---|---|
| Provider Enumeration Date | 11/17/2015 |
| Last Update Date | 12/09/2015 |
| Medicare PECOS PAC ID | 9133421985 |
|---|---|
| Medicare Enrollment ID | O20160111001669 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588038343 | NPI | - | NPPES |
| 4301060252 | Other | MI | STATE LICENSE |
| 4301083821 | Other | MI | STATE LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | 4301060252 (Michigan) | Primary |
| Provider Name | Masroor U Haq |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1417064502 PECOS PAC ID: 8820983927 Enrollment ID: I20040218000204 |
| Provider Name | Marisa C Olafsson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1639280068 PECOS PAC ID: 3870668593 Enrollment ID: I20080814000679 |
| Provider Name | Suzan C Robarge |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104848530 PECOS PAC ID: 3375691595 Enrollment ID: I20090428000209 |
| Provider Name | Humera Athar |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1073720900 PECOS PAC ID: 4486794153 Enrollment ID: I20091211000086 |
| Provider Name | Melissa L Kozlowski |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1831228741 PECOS PAC ID: 0941460463 Enrollment ID: I20120321000048 |
| Provider Name | Moray J Wehab |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1285982710 PECOS PAC ID: 6709010184 Enrollment ID: I20131018001035 |
| Provider Name | Colleen M Biafore |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558788133 PECOS PAC ID: 0244462638 Enrollment ID: I20140417001833 |
| Provider Name | Nicole M Minty |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1982940839 PECOS PAC ID: 0345569331 Enrollment ID: I20150423002566 |
| Provider Name | Kristen E Jones |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1477007490 PECOS PAC ID: 7214225523 Enrollment ID: I20161019000487 |
| Provider Name | Amanda Louise Stamm |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1588826556 PECOS PAC ID: 4082992573 Enrollment ID: I20161104000129 |
| Provider Name | Aliah F Azmeh |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1356874671 PECOS PAC ID: 3476827312 Enrollment ID: I20170915002774 |
| Provider Name | Patricia Campbell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851941363 PECOS PAC ID: 8921330226 Enrollment ID: I20191105001968 |
| Provider Name | Sharman Rachele Russ-silberman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1639414170 PECOS PAC ID: 6608205067 Enrollment ID: I20200406002038 |
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