Stacey R Gedeon is a Clinical in Houghton Lake, Michigan. Stacey R Gedeon practices all healthcare services and medical treatments related to Clinical. The NPI Number for Stacey R Gedeon is 1336172485. The last update date is 2016-10-15.
Stacey R Gedeon's current location address is 9249 W Lake City Rd, Houghton Lake, Michigan. You can contact this provider via phone number 9894225122 and fax number 9894224378. The mailing address for Stacey R Gedeon is 9249 W Lake City Rd, Houghton Lake, Michigan. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Stacey R Gedeon |
|---|---|
| Address | 9249 W Lake City Rd, Houghton Lake, Michigan |
| Phone Number | 9894225122 |
| Fax Number | 9894224378 |
| Sole Proprietor | N |
| Credentials | PSYD |
NPI Number Detail
| NPI Number | 1336172485 |
|---|---|
| Provider Enumeration Date | 2006-07-09 |
| Last Updated Date | 2016-10-15 |
Provider Mailing Address Detail
| Address | 9249 W Lake City Rd |
|---|---|
| City | Houghton Lake |
| State | Michigan (MI) |
| Post Code | 486299602 |
| Phone Number | 9894225122 |
| Fax Number | 9894224378 |
Provider's Primary Taxonomy Detail
| Speciality | Clinical |
|---|---|
| Taxonomy | 103Tc0700X |
| Licence No | 6301010429 |
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Definition: A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| G27604070 | MI | MEDICARE PTAN |
Post Comment/ Review Below
What is the unique provider identifier assigned to Stacey R Gedeon?
The Stacey R Gedeon has been issued the NPI (National Provider Identifier) 1336172485 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code is a unique identification number for healthcare providers.
Could you please share the complete physical address where Stacey R Gedeon is geographically located?
The Stacey R Gedeon is physically situated at the following location: 9249 W Lake City Rd, Houghton Lake, MI, 486299602.
What is Stacey R Gedeon's specialized area of practice, and what is the corresponding taxonomy classification code for this field?
The Stacey R Gedeon's specialized field of practice is Clinical, and the corresponding taxonomy code that categorizes this area of specialization is 103Tc0700X.
When did the Stacey R Gedeon receive its 1336172485?
The Stacey R Gedeon was issued its 1336172485 on 2006-07-09, which is the date when the organization was assigned this unique identifier.
When was the information regarding Stacey R Gedeon most recently updated?
The details pertaining to the Stacey R Gedeon, including its address, specialty, and other relevant information, were last refreshed on 2016-10-15.