Provider Demographics
NPI:1588428338
Name:AGILITY OF MENTAL HEALTH, LLC
Entity type:Organization
Organization Name:AGILITY OF MENTAL HEALTH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR OF PSYCHOLOGY
Authorized Official - Prefix:DR
Authorized Official - First Name:KATIE
Authorized Official - Middle Name:
Authorized Official - Last Name:FURTON
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD, LP
Authorized Official - Phone:734-637-6152
Mailing Address - Street 1:15642 GARRISON LN
Mailing Address - Street 2:
Mailing Address - City:SOUTHGATE
Mailing Address - State:MI
Mailing Address - Zip Code:48195-3446
Mailing Address - Country:US
Mailing Address - Phone:734-637-6152
Mailing Address - Fax:
Practice Address - Street 1:3200 GREENFIELD RD
Practice Address - Street 2:SUITE 300
Practice Address - City:DEARBORN
Practice Address - State:MI
Practice Address - Zip Code:48120
Practice Address - Country:US
Practice Address - Phone:734-637-6152
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-12
Last Update Date:2024-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty