Provider Demographics
NPI:1063991594
Name:ABADI PSYCHOLOGY, PLLC
Entity type:Organization
Organization Name:ABADI PSYCHOLOGY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL PSYCHOLOGIST/ADMINSTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:LAYAL
Authorized Official - Middle Name:
Authorized Official - Last Name:ABADI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:313-903-4098
Mailing Address - Street 1:4419 CAMPBELL ST
Mailing Address - Street 2:
Mailing Address - City:DEARBORN HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48125-2722
Mailing Address - Country:US
Mailing Address - Phone:313-903-4098
Mailing Address - Fax:
Practice Address - Street 1:2350 WASHTENAW AVE STE 7
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48104-4525
Practice Address - Country:US
Practice Address - Phone:313-903-4098
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-07
Last Update Date:2018-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty