Provider Demographics
NPI:1538350376
Name:STACEY LYNN BIEKE-RAPSKE
Entity type:Organization
Organization Name:STACEY LYNN BIEKE-RAPSKE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:STACEY
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:BIEKE-RAPSKE
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD, LLP
Authorized Official - Phone:586-871-8451
Mailing Address - Street 1:53525 ATHERTON ST
Mailing Address - Street 2:
Mailing Address - City:NEW BALTIMORE
Mailing Address - State:MI
Mailing Address - Zip Code:48047-1062
Mailing Address - Country:US
Mailing Address - Phone:586-871-8451
Mailing Address - Fax:
Practice Address - Street 1:1202 WALTON BLVD
Practice Address - Street 2:SUITE 212
Practice Address - City:ROCHESTER HILLS
Practice Address - State:MI
Practice Address - Zip Code:48307-6917
Practice Address - Country:US
Practice Address - Phone:586-871-8451
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-07
Last Update Date:2017-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301013577171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171W00000XOther Service ProvidersContractorGroup - Multi-Specialty