Organization · Type 2 NPI

Henry Ford Health Eastwood Behavioral Health

Psychologist · St. Clair Shores, MI

NPI number 1104044676 Active

Practice location

24055 Jefferson Ave Ste 103
St. Clair Shores, MI 48080-1511

Call (586) 445-2210 Map

Fax (586) 445-0700

Mailing address

PO Box 670884
Detroit, MI 48267-0884

Specialties and licenses

Taxonomy	Code	License
Counselor	101Y00000X	None listed
Psychologist Primary	103T00000X	None listed
Social Worker	104100000X	None listed
Marriage & Family Therapist	106H00000X	None listed
Psychiatry Physician	2084P0800X	None listed

Psychologist: A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustmen…

2 other providers at this address

Other psychologist providers in St. Clair Shores

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NPI record

NPI: 1104044676
Entity type: Organization (Type 2)
Issued: Apr 23, 2007
Last updated: Jun 10, 2026
Status: Active
Subpart: Yes of Eastwood Community Clinics

Other names

<unavail>
Eastwood Clinics · doing business as
Eastwood Clinics · doing business as

Authorized official

Kimberly Cebalt
Director
(313) 874-6764

Verify this record

This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1104044676

Henry Ford Health Eastwood Behavioral Health's National Provider Identifier is 1104044676, issued on Apr 23, 2007. The primary taxonomy on file is Psychologist (103T00000X), and the practice location is in St. Clair Shores, MI. The record was last updated on Jun 10, 2026.