Organization Active NPI

Partners in Change: Psychological & Community Services, PLC

  • Psychologist
  • Midland, MI
National Provider Identifier
1093984817
Registry record updated Mar 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
6301009535 Issued in MI
Legal business name
PARTNERS IN CHANGE: PSYCHOLOGICAL & COMMUNITY SERVICES, PLC
Practice address
720 W Wackerly St
Midland, MI 48640-2769
Phone
(989) 832-2165
Fax
(989) 839-4376
NPI assigned
Feb 26, 2008
Last updated
Mar 16, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 16, 2021

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

Authorized official

Name
Joseph Date
Title
Business Director
Phone
(989) 832-2165

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 6301009535 MI Primary

Addresses

Primary practice location

720 W Wackerly St
Midland, MI 48640-2769

Mailing address

PO Box 2875
Midland, MI 48641-2875
Phone (989) 832-2165

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080723000347 MI Part B Supplier - Clinic/Group Practice 7719050814 Receives reassigned benefits from 39 practitioners
Practice locations: Midland, MI; Mt Pleasant, MI

National Provider Directory

National Provider Directory

Locations

720 W Wackerly St
Midland, MI 48640
Phone (989) 798-0539

720 W Wackerly St
Ste 11
Midland, MI 48640
Phone (989) 832-2165

720 W Wackerly St
Ste 4
Midland, MI 48640
Phone (989) 832-2165

211 S Crapo St
Ste M
Mt Pleasant, MI 48858
Phone (989) 463-1101

4912 E Pickard St
Mt Pleasant, MI 48858
Phone (989) 533-1037

Practitioners & affiliated clinicians

Practitioners 75

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 75

NPI Registry JSON

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

{
    "created_epoch": "1203984000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1615852800000",
    "number": "1093984817",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2875",
            "city": "MIDLAND",
            "state": "MI",
            "postal_code": "486412875",
            "telephone_number": "989-832-2165",
            "fax_number": "989-839-4376"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "720 W WACKERLY ST",
            "city": "MIDLAND",
            "state": "MI",
            "postal_code": "486402769",
            "telephone_number": "989-832-2165",
            "fax_number": "989-839-4376"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARTNERS IN CHANGE: PSYCHOLOGICAL & COMMUNITY SERVICES, PLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-26",
        "last_updated": "2021-03-16",
        "certification_date": "2021-03-16",
        "status": "A",
        "authorized_official_last_name": "DATE",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_title_or_position": "BUSINESS DIRECTOR",
        "authorized_official_telephone_number": "989-832-2165"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MI",
            "license": "6301009535",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Midland, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2021; 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.