Provider Demographics
NPI:1063422996
Name:WEEKS, BRIAN A (PSYD)
Entity type:Individual
Prefix:
First Name:BRIAN
Middle Name:A
Last Name:WEEKS
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1460 WALTON BLVD STE 202
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48309-1779
Mailing Address - Country:US
Mailing Address - Phone:248-650-5113
Mailing Address - Fax:248-601-9991
Practice Address - Street 1:1460 WALTON BLVD
Practice Address - Street 2:202
Practice Address - City:ROCHESTER HILLS
Practice Address - State:MI
Practice Address - Zip Code:48309
Practice Address - Country:US
Practice Address - Phone:248-650-5113
Practice Address - Fax:248-601-9991
Is Sole Proprietor?:No
Enumeration Date:2006-08-09
Last Update Date:2018-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301009224103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
P73898Medicare UPIN