Peter M Lisiecki PHD PC Inc

Primary specialty

PsychologistTaxonomy code 103T00000X

License

6301003173 Issued in MI

Legal business name

PETER M LISIECKI PHD PC INC

Practice address

7960 W. Grand River
Ste 120
Brighton, MI 48114-7335

Phone

(810) 227-1999

Fax

(810) 225-2265

NPI assigned

Feb 12, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Peter Michael Lisiecki

Title

President

Phone

(810) 227-1999

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Marni Anne Gauci, PH.D.

  • Psychologist
  • Brighton, MI
  • NPI 1245664655
  NPD (past)
• Jacqueline Rene Lisiecki, MSW

  • Clinical Social Worker
  • Brighton, MI
  • NPI 1538286471
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1171238400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1276732800000",
    "number": "1043352701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7960 GRAND RIVER RD STE 120",
            "city": "BRIGHTON",
            "state": "MI",
            "postal_code": "481147335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7960 W. GRAND RIVER",
            "address_2": "STE 120",
            "city": "BRIGHTON",
            "state": "MI",
            "postal_code": "481147335",
            "telephone_number": "810-227-1999",
            "fax_number": "810-225-2265"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PETER M LISIECKI PHD PC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-12",
        "last_updated": "2010-06-17",
        "status": "A",
        "authorized_official_last_name": "LISIECKI",
        "authorized_official_first_name": "PETER",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "810-227-1999",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": "MI",
            "license": "6301003173",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM PIN",
            "identifier": "680D745030",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUE OPTIONS PIN",
            "identifier": "045199",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• People & Pets Pharmacy, LLC.
• Lyndsey Perez
• Periodontal Specialists Group
• Ignazio Dominic Perna, DPM
• Perspectives Therapy Services LLC
• Michael Joseph Peters, PA-C
• Brian Jon Petersburg, D.D.S.
• Jay William Peterson, PA-C
• Physiotherapy Associates Inc
• Taylor Bell Picano, CCC-SLP

• Psychologist in Brighton, MI
• Providers in Brighton, MI by specialty
• Psychologist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.