NPIMap

Organization Active NPI

List Psychological Services, PLC

  • Clinical Social Worker
  • Sandusky, MI
National Provider Identifier
1174267116
Registry record updated May 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
LIST PSYCHOLOGICAL SERVICES, PLC
Practice address
33 W Sanilac Rd
Sandusky, MI 48471-1036
Phone
(810) 667-4500
NPI assigned
Apr 26, 2022
Last updated
May 23, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
LIST PSYCHOLOGICAL SERVICES, PLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 23, 2025

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

Authorized official

Name
Jacqueline Diane List
Title
Ceo
Phone
(989) 672-6160

Specialties & licenses 8

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 Primary
Marriage & Family TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 106H00000X
Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0800X
Addiction Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0802X

Addresses

Primary practice location

33 W Sanilac Rd
Sandusky, MI 48471-1036

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
NAOtherNA

Electronic endpoints 3

TypeEndpointUseAffiliation
Direct Messaging Address ListPsychologicalServices.DianeList@130916.advancedmd-direct.com
Direct Messaging Address ListPsychologicalServices.DianeList@130916.advancedmd-direct.com
Direct Messaging Address ListPsychologicalServices.DianeList@130916.advancedmd-direct.com

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.

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.

Locations

110 E Huron Ave
Bad Axe, MI 48413
Phone (989) 453-3051

65 Patrick Dr
Bad Axe, MI 48413
Phone (517) 269-2960

2110 16th St
Ste 8
Bay City, MI 48708
Phone (989) 460-1000

3720 Wilder Rd
Ste B
Bay City, MI 48706
Phone (989) 460-1000

3741 Wilder Rd
Ste A
Bay City, MI 48706
Phone (989) 460-1000

3741 Wilder Rd
Ste C
Bay City, MI 48706
Phone (517) 684-7977

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

350 N Court St
Ste 205
Lapeer, MI 48446
Phone (810) 667-4500

350 N Court St
Ste 304
Lapeer, MI 48446
Phone (810) 667-4500

624 W Nepessing St
Lapeer, MI 48446
Phone (810) 667-4500

14 Lincoln St
Sandusky, MI 48471
Phone (810) 648-0668

2 N Elk St
Sandusky, MI 48471
Phone (810) 682-4008

Interoperability endpoints

  • Direct secure messaging: listpsychologicalservices.dianelist@130916.advancedmd-direct.com

Practitioners & affiliated clinicians

Practitioners 55

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 55

NPI Registry JSON

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

{
    "created_epoch": "1650931200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1747958400000",
    "number": "1174267116",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33 W SANILAC RD",
            "city": "SANDUSKY",
            "state": "MI",
            "postal_code": "484711036",
            "telephone_number": "810-667-4500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIST PSYCHOLOGICAL SERVICES, PLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LIST PSYCHOLOGICAL SERVICES, PLC",
        "enumeration_date": "2022-04-26",
        "last_updated": "2025-05-23",
        "certification_date": "2025-05-23",
        "status": "A",
        "authorized_official_last_name": "LIST",
        "authorized_official_first_name": "JACQUELINE",
        "authorized_official_middle_name": "DIANE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "989-672-6160"
    },
    "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": true
        },
        {
            "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
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NA",
            "identifier": "NA",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ListPsychologicalServices.DianeList@130916.advancedmd-direct.com",
            "affiliation": "N",
            "address_1": "2 N Elk St",
            "city": "Sandusky",
            "state": "MI",
            "country_code": "US",
            "postal_code": "484711130",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ListPsychologicalServices.DianeList@130916.advancedmd-direct.com",
            "affiliation": "N",
            "address_1": "14 Lincoln Street",
            "city": "Sandusky",
            "state": "MI",
            "country_code": "US",
            "postal_code": "48471",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ListPsychologicalServices.DianeList@130916.advancedmd-direct.com",
            "affiliation": "N",
            "address_1": "33 W Sanilac Rd",
            "city": "Sandusky",
            "state": "MI",
            "country_code": "US",
            "postal_code": "484711036",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Sandusky, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2025; 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.