Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | 6301014521 | MI |
Y | 103TC0700X | Clinical Psychologist | 6301014521 | MI |
N | 102L00000X | Psychologist | 6301014521 | MI |
N | 103T00000X | Psychologist | 6301014521 | MI |
N | 103TA0400X | Addiction Psychologist (Substance Use Disorder) | 6301014521 | MI |
N | 103TA0700X | Adult Development & Aging Psychologist | 6301014521 | MI |
N | 103TB0200X | Cognitive & Behavioral Psychologist | 6301014521 | MI |
N | 103G00000X | Clinical Psychologist | 6301014521 | MI |
N | 103TC0700X | Clinical Psychologist | 6301014521 | MI |
N | 103TC2200X | Clinical Child & Adolescent Psychologist | ||
N | 103TF0000X | Family Psychologist | 6301014521 | MI |
N | 103TF0200X | Forensic Psychologist | 6301014521 | MI |
N | 103TH0004X | Health Psychologist | ||
N | 103TM1800X | Intellectual & Developmental Disabilities | 6301014521 | MI |
N | 103TP2701X | Group Psychotherapist | 6301014521 | MI |
NPI | 1366493462 |
---|---|
Provider Name | Dr. Todd Russell Silverstein |
First Address | Iron Mountain, MI 49801-4760 |
Second Address | Iron Mountain, MI 49801-4760 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/05/2006 |
Last Update Date | 04/06/2021 |