Provider Demographics
NPI:1538602784
Name:MCCASKILL FAMILY SERVICES
Entity type:Organization
Organization Name:MCCASKILL FAMILY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:A
Authorized Official - Last Name:MCCASKILL
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:734-416-9098
Mailing Address - Street 1:2040 GRAND RIVER ANX
Mailing Address - Street 2:STE. 300
Mailing Address - City:BRIGHTON
Mailing Address - State:MI
Mailing Address - Zip Code:48114-5313
Mailing Address - Country:US
Mailing Address - Phone:734-416-9098
Mailing Address - Fax:734-416-0158
Practice Address - Street 1:409 PLYMOUTH RD
Practice Address - Street 2:SUITE 250
Practice Address - City:PLYMOUTH
Practice Address - State:MI
Practice Address - Zip Code:48170-1497
Practice Address - Country:US
Practice Address - Phone:734-416-9098
Practice Address - Fax:734-416-0158
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-21
Last Update Date:2016-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301012563101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty