Provider Demographics
NPI:1861616807
Name:INTERIM ASSOCIATES
Entity type:Organization
Organization Name:INTERIM ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT OP PSYCHOTHERAPIST
Authorized Official - Prefix:DR
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:S
Authorized Official - Last Name:MCFARLANE
Authorized Official - Suffix:
Authorized Official - Credentials:MSW MA
Authorized Official - Phone:231-843-8222
Mailing Address - Street 1:601 E LUDINGTON AVE
Mailing Address - Street 2:SUITE 2
Mailing Address - City:LUDINGTON
Mailing Address - State:MI
Mailing Address - Zip Code:49431-2222
Mailing Address - Country:US
Mailing Address - Phone:231-843-8222
Mailing Address - Fax:
Practice Address - Street 1:601 E LUDINGTON AVE
Practice Address - Street 2:SUITE 2
Practice Address - City:LUDINGTON
Practice Address - State:MI
Practice Address - Zip Code:49431-2222
Practice Address - Country:US
Practice Address - Phone:231-843-8222
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301011053103T00000X
MI6801069999104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
Not Answered104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIP16370001Medicare ID - Type UnspecifiedMEMBER NUMBER
MI0P16370Medicare ID - Type UnspecifiedGROPU PROVIDER NUMBER