Provider Demographics
NPI:1992820450
Name:WILLIAM C. HORTON, PSY.D., PC
Entity type:Organization
Organization Name:WILLIAM C. HORTON, PSY.D., PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:CHARLES
Authorized Official - Last Name:HORTON
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:248-377-9428
Mailing Address - Street 1:380 N OLD WOODWARD AVE
Mailing Address - Street 2:STE. 156
Mailing Address - City:BIRMINGHAM
Mailing Address - State:MI
Mailing Address - Zip Code:48009-5347
Mailing Address - Country:US
Mailing Address - Phone:248-377-9428
Mailing Address - Fax:248-594-7663
Practice Address - Street 1:380 N OLD WOODWARD AVE
Practice Address - Street 2:STE. 156
Practice Address - City:BIRMINGHAM
Practice Address - State:MI
Practice Address - Zip Code:48009-5347
Practice Address - Country:US
Practice Address - Phone:248-377-9428
Practice Address - Fax:248-594-7663
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-20
Last Update Date:2007-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301006621174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty