NPIMap

Organization Active NPI

Geriatric Psychiatric Services PLLC

  • Clinical Psychologist
  • Indianapolis, IN
National Provider Identifier
1073753323
Registry record updated Jul 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
Legal business name
GERIATRIC PSYCHIATRIC SERVICES PLLC
Practice address
9465 Counselors Row
Suite 200
Indianapolis, IN 46240-6423
Phone
(586) 620-8100
Fax
(866) 227-7418
NPI assigned
Feb 26, 2009
Last updated
Jul 25, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
TOTAL CARE SOLUTIONS, SCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 25, 2024

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

Authorized official

Name
Mr. Robert A Clemente, ESQ.
Title
Admin Director
Phone
(586) 620-8100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X Primary

Addresses

Primary practice location

9465 Counselors Row
Suite 200
Indianapolis, IN 46240-6423

Mailing address

39465 W 14 Mile Rd
Novi, MI 48377-1600
Phone (877) 906-9699

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090424000362 IN Part B Supplier - Clinic/Group Practice 6204837388 Receives reassigned benefits from 1 practitioner
3 other NPIs on this enrollment
Practice locations: Indianapolis, IN

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 3

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Geriatric Psychiatric Services PLLC8 organizations share this tax ID, including this one
Part of
Total Care Solutions SC

Other organizations with this tax ID 7

Organizations that report the same tax identification number in the National Provider Directory.

Locations

8450 S Harlem Ave
Bridgeview, IL 60455
Phone (708) 598-2605

2710 N Clark St
Chicago, IL 60614
Phone (708) 955-8033

1721 Moon Lake Blvd
Hoffman Estates, IL 60169
Phone (708) 378-3585

300 W Lowell Ave
Pontiac, IL 61764
Phone (815) 842-1181

420 N Niles Ave
South Bend, IN 46617
Phone (248) 762-0893

675 Wagner Dr
Battle Creek, MI 49017
Phone (269) 969-6244

2515 5th Ave S
Escanaba, MI 49829
Phone (906) 786-6533

30350 W 12 Mile Rd
Farmington Hills, MI 48334
Phone (248) 851-9640

11941 Belsay Rd
Grand Blanc, MI 48439
Phone (810) 694-1970

1330 Grand Pointe Ct
Grand Blanc, MI 48439
Phone (810) 344-3518

240 E North St
Hastings, MI 49058
Phone (269) 945-9564

1805 W Pyle Dr
Kingsford, MI 49802
Phone (906) 774-1530

220 S Hughston St
Mc Bain, MI 49657
Phone (231) 825-2990

900 Maas St
Negaunee, MI 49866
Phone (906) 225-7709

25300 Lahser Rd
Southfield, MI 48033
Phone (248) 354-3222

22601 E 9 Mile Rd
St Clr Shores, MI 48080
Phone (586) 772-4300

517 S Erie St
Three Rivers, MI 49093
Phone (269) 273-8661

1050 4 Mile Rd NW
Walker, MI 49544
Phone (616) 685-7000

28800 Ryan Rd
Ste 320C
Warren, MI 48092
Phone (586) 620-8100

34330 Van Born Rd
Wayne, MI 48184
Phone (734) 721-0740

8365 N Newburgh Rd
#Four
Westland, MI 48185
Phone (734) 416-2000

285 N State St
Zeeland, MI 49464
Phone (616) 772-4641

3231 Manley Rd
Maumee, OH 43537
Phone (419) 865-1248

Practitioners & affiliated clinicians

Practitioners 175

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 175

NPI Registry JSON

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

{
    "created_epoch": "1235606400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721865600000",
    "number": "1073753323",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39465 W 14 MILE RD",
            "city": "NOVI",
            "state": "MI",
            "postal_code": "483771600",
            "telephone_number": "877-906-9699",
            "fax_number": "888-483-0118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9465 COUNSELORS ROW",
            "address_2": "SUITE 200",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462406423",
            "telephone_number": "586-620-8100",
            "fax_number": "866-227-7418"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GERIATRIC PSYCHIATRIC SERVICES PLLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "TOTAL CARE SOLUTIONS, SC",
        "enumeration_date": "2009-02-26",
        "last_updated": "2024-07-25",
        "certification_date": "2024-07-25",
        "status": "A",
        "authorized_official_last_name": "CLEMENTE",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "ADMIN DIRECTOR",
        "authorized_official_telephone_number": "586-620-8100",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "ESQ."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.