Provider Demographics
NPI:1528285574
Name:PICH, PATRICIA ANNE (PHD, LPC)
Entity type:Individual
Prefix:DR
First Name:PATRICIA
Middle Name:ANNE
Last Name:PICH
Suffix:
Gender:F
Credentials:PHD, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:49564 SANDRA DR
Mailing Address - Street 2:
Mailing Address - City:SHELBY TOWNSHIP
Mailing Address - State:MI
Mailing Address - Zip Code:48315-3537
Mailing Address - Country:US
Mailing Address - Phone:586-949-7579
Mailing Address - Fax:
Practice Address - Street 1:45200 STERRITT ST
Practice Address - Street 2:SUITE # 105
Practice Address - City:SHELBY TWP
Practice Address - State:MI
Practice Address - Zip Code:48317-5844
Practice Address - Country:US
Practice Address - Phone:586-436-3653
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401005950101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health