NPIMap

Organization Active NPI

List Psychological Services, PLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Bad Axe, MI
National Provider Identifier
1154894673
Registry record updated Jan 8, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
LIST PSYCHOLOGICAL SERVICES, PLC
Practice address
110 E Huron Ave
Bad Axe, MI 48413-1312
Phone
(989) 672-6160
Fax
(989) 672-5649
NPI assigned
Jan 8, 2019
Organization subpart
Yes
Parent organization
LIST PSYCHOLOGICAL SERVICES, PLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 8, 2019

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

Authorized official

Name
Mrs. Carin Ann Montei
Title
Contract Supervisor
Phone
(989) 672-6160

Specialties & licenses 9

Specialty (taxonomy)CodeLicenseStatePrimary
CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101Y00000X
Addiction (Substance Use Disorder) CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YA0400X
Professional CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YP2500X
Clinical PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC0700X
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X
Marriage & Family TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 106H00000X
Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0800X
Addiction Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0802X
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary

Addresses

Primary practice location

110 E Huron Ave
Bad Axe, MI 48413-1312

Mailing address

443 N State St
Caro, MI 48723-1539
Phone (989) 672-6160

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20031110000689 MI Part B Supplier - Clinic/Group Practice 6709799323 Receives reassigned benefits from 28 practitioners
10 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Lapeer, MI; Sandusky, MI; Saginaw, MI; Pigeon, MI; Caro, MI; Bay City, MI; Bad Axe, MI
O20040322001040 MI Part B Supplier - Clinic/Group Practice 6709799323 Receives reassigned benefits from 8 practitioners
10 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Sandusky, MI; Saginaw, MI; Pigeon, MI; Lapeer, MI; Caro, MI; Bay City, MI; Bad Axe, MI

Other NPIs on the same Medicare enrollment 10

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

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
23D2187418List Psychological Services, PLC110 E Huron Avenue Suite a, Bad Axe, MI 48413Certificate of waiverJun 30, 2026

National Provider Directory

National Provider Directory
Tax ID family
List Psychological PLC9 organizations share this tax ID, including this one
Part of
List Psychological PLC

Other organizations with this tax ID 8

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

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1546905600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1546905600000",
    "number": "1154894673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "443 N STATE ST",
            "city": "CARO",
            "state": "MI",
            "postal_code": "487231539",
            "telephone_number": "989-672-6160",
            "fax_number": "989-672-5649"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 E HURON AVE",
            "city": "BAD AXE",
            "state": "MI",
            "postal_code": "484131312",
            "telephone_number": "989-672-6160",
            "fax_number": "989-672-5649"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIST PSYCHOLOGICAL SERVICES, PLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LIST PSYCHOLOGICAL SERVICES, PLC",
        "enumeration_date": "2019-01-08",
        "last_updated": "2019-01-08",
        "status": "A",
        "authorized_official_last_name": "MONTEI",
        "authorized_official_first_name": "CARIN",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "CONTRACT SUPERVISOR",
        "authorized_official_telephone_number": "989-672-6160",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0802X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Addiction Psychiatry",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bad Axe, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.