Daniel Wall, PH.D., LP

Primary specialty

PsychologistTaxonomy code 103T00000X

License

6301014904 Issued in MI

Practice address

4000 W Walton Blvd Ste B
Waterford, MI 48329-4191

Phone

(248) 461-6266

Fax

(248) 791-7905

NPI assigned

Nov 8, 2011

Sex

Male

Sole proprietor

Yes

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

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Lifelens Psychological and Counseling ServicesGroup PAC ID 0143544320, 9 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

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

• Lifelens Psychological and Counseling Services

  • Psychologist
  • Waterford, MI
  • NPI 1083015499
  Medicare reassignment Care Compare group NPD Authorized official

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

{
    "created_epoch": "1320710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686096000000",
    "number": "1184901969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4000 W WALTON BLVD STE B",
            "city": "WATERFORD",
            "state": "MI",
            "postal_code": "483294191",
            "telephone_number": "248-881-6698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4000 W WALTON BLVD STE B",
            "city": "WATERFORD",
            "state": "MI",
            "postal_code": "483294191",
            "telephone_number": "248-461-6266",
            "fax_number": "248-791-7905"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALL",
        "first_name": "DANIEL",
        "name_prefix": "Dr.",
        "credential": "PH.D., LP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-11-08",
        "last_updated": "2023-06-07",
        "certification_date": "2023-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MI",
            "license": "6301014904",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Visiting Nurse Services of Michigan
• Vna Caring Home Support, Inc
• Walgreen Co
• Walgreen Co
• Lorell Walker
• Walton Medical PC
• William Scott Ward, DDS
• Daniel Warden, M.D.
• Lori Ann Warholak, MA, LPC
• John Patrick Warr, D.D.S.

• Psychologist in Waterford, MI
• Providers in Waterford, MI by specialty
• Psychologist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.