Peter Michael Lisiecki, PH.D

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

6301003173 Issued in MI

Practice address

7960 Grand River Rd
Suite 120
Brighton, MI 48114-7330

Phone

(810) 227-1999

Fax

(810) 225-2265

NPI assigned

Feb 21, 2010

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Peter M Lisiecki PHD PC Inc

  • Psychologist
  • Brighton, MI
  • NPI 1043352701
  Authorized official Same address or phone

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

{
    "created_epoch": "1266710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1266710400000",
    "number": "1164744983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7960 GRAND RIVER RD",
            "address_2": "SUITE 120",
            "city": "BRIGHTON",
            "state": "MI",
            "postal_code": "481147330",
            "telephone_number": "810-227-1999",
            "fax_number": "810-225-2265"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7960 GRAND RIVER RD",
            "address_2": "SUITE 120",
            "city": "BRIGHTON",
            "state": "MI",
            "postal_code": "481147330",
            "telephone_number": "810-227-1999",
            "fax_number": "810-225-2265"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LISIECKI",
        "first_name": "PETER",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "PH.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-02-21",
        "last_updated": "2010-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6301003173",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lori K. Lingo, M. ED., CCCA
• Maureen Linnell-Peart, LMSW
• Howard David Lipkin, D.O.
• Lisa Wagner
• Jacqueline Rene Lisiecki, MSW
• Beth Litkewycz
• Livingston Center of Allergy, Sinus & Asthma, PC
• Livingston Dental Sleep Therapy PLLC
• Livingston ENT
• Livingston Medical Center PC

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 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.