Provider Demographics
NPI:1861422289
Name:MACFARLANE, RICHARD WAYNE (MA,LLP)
Entity type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:WAYNE
Last Name:MACFARLANE
Suffix:
Gender:M
Credentials:MA,LLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:43996 WOODWARD AVE
Mailing Address - Street 2:
Mailing Address - City:BLOOMFIELD HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48302-0548
Mailing Address - Country:US
Mailing Address - Phone:248-338-2988
Mailing Address - Fax:248-338-1322
Practice Address - Street 1:43996 WOODWARD AVE
Practice Address - Street 2:
Practice Address - City:BLOOMFIELD HILLS
Practice Address - State:MI
Practice Address - Zip Code:48302-5027
Practice Address - Country:US
Practice Address - Phone:248-338-2988
Practice Address - Fax:248-338-1322
Is Sole Proprietor?:No
Enumeration Date:2006-07-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301007318103TA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TA0400XBehavioral Health & Social Service ProvidersPsychologistAddiction (Substance Use Disorder)