Provider Demographics
NPI:1063124584
Name:DR. CHRIS ALLEN SHREVE PHD PLLC
Entity type:Organization
Organization Name:DR. CHRIS ALLEN SHREVE PHD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRIS
Authorized Official - Middle Name:ALLEN
Authorized Official - Last Name:SHREVE
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:313-587-7388
Mailing Address - Street 1:220 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:ROYAL OAK
Mailing Address - State:MI
Mailing Address - Zip Code:48067-2676
Mailing Address - Country:US
Mailing Address - Phone:313-587-7388
Mailing Address - Fax:734-629-1778
Practice Address - Street 1:220 S MAIN ST
Practice Address - Street 2:
Practice Address - City:ROYAL OAK
Practice Address - State:MI
Practice Address - Zip Code:48067-2676
Practice Address - Country:US
Practice Address - Phone:313-587-7388
Practice Address - Fax:734-629-1778
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-15
Last Update Date:2022-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty