Provider Demographics
NPI:1518361567
Name:PAUL D WINKLER BEHAVIORAL HEALTH SERVICES PLC
Entity type:Organization
Organization Name:PAUL D WINKLER BEHAVIORAL HEALTH SERVICES PLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CLINICAL PSYCHOLOGIST/ DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:DOUGLAS
Authorized Official - Last Name:WINKLER
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:231-642-4642
Mailing Address - Street 1:2240 S AIRPORT RD W
Mailing Address - Street 2:SUITE C
Mailing Address - City:TRAVERSE CITY
Mailing Address - State:MI
Mailing Address - Zip Code:49684-4714
Mailing Address - Country:US
Mailing Address - Phone:231-642-4642
Mailing Address - Fax:231-642-4640
Practice Address - Street 1:2240 S AIRPORT RD W
Practice Address - Street 2:SUITE C
Practice Address - City:TRAVERSE CITY
Practice Address - State:MI
Practice Address - Zip Code:49684-4714
Practice Address - Country:US
Practice Address - Phone:231-642-4642
Practice Address - Fax:231-642-4640
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-20
Last Update Date:2014-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301005613103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty