Provider Demographics
NPI:1366296782
Name:KARPACK, BRETT MICHAEL
Entity type:Individual
Prefix:
First Name:BRETT
Middle Name:MICHAEL
Last Name:KARPACK
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7042 MEADOWBROOK DR
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:MI
Mailing Address - Zip Code:48187-3554
Mailing Address - Country:US
Mailing Address - Phone:734-890-3984
Mailing Address - Fax:
Practice Address - Street 1:42207 ANN ARBOR RD E
Practice Address - Street 2:
Practice Address - City:PLYMOUTH
Practice Address - State:MI
Practice Address - Zip Code:48170-4364
Practice Address - Country:US
Practice Address - Phone:248-985-3580
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-12
Last Update Date:2024-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6362002753103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist