Provider Demographics
NPI:1841472362
Name:KAYE, PAUL (PHD)
Entity type:Individual
Prefix:
First Name:PAUL
Middle Name:
Last Name:KAYE
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25504 SHERWOOD DR
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON WOODS
Mailing Address - State:MI
Mailing Address - Zip Code:48070-1752
Mailing Address - Country:US
Mailing Address - Phone:248-399-2122
Mailing Address - Fax:248-399-2122
Practice Address - Street 1:25504 SHERWOOD DR
Practice Address - Street 2:
Practice Address - City:HUNTINGTON WOODS
Practice Address - State:MI
Practice Address - Zip Code:48070-1752
Practice Address - Country:US
Practice Address - Phone:248-399-2122
Practice Address - Fax:248-399-2122
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-27
Last Update Date:2007-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301002096103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI11280134OtherCAQH
MI1457458374OtherNPI-GROUP NUMBER
MI1457458374OtherNPI-GROUP NUMBER