Lori Stephanie Harrison, M.A.
Individual provider Active NPI Clinical Psychologist · Taylor, MI
NPI 1205933637 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1205933637
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Psychologist 103TC0700X
- License
- 6301008233 (MI)
- Practice address
- 20600 Eureka Rd
Suite 819
Taylor, MI 48180-5343 - Phone
- (734) 285-8282
- NPI assigned
- Sep 20, 2006
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Clinical Psychologist
- Education
- Other, 1991
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Pure Psychiatry of Michigan PLLC
Practice addresses (Care Compare)
34841 Veterans PLZ
Wayne, MI 48184-1733
Phone (313) 292-7640
375 Eureka Rd
Suite B
Wyandotte, MI 48192-5839
Phone (734) 258-8386
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240924001028 | MI | Practitioner - Clinical Psychologist | 9739320342 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6301008233 | MI | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pure Psychiatry of Michigan PLLC | Current |
Accepting new patients | |
| Downriver Mental Health Clinic PC | Past |
Accepting new patients |
Locations
2422 Jolly Rd
Ste 100A
Okemos, MI 48864
Phone (517) 853-1358
34841 Veterans Plz
Wayne, MI 48184
Phone (313) 292-7640
Interoperability endpoints
- purepsychiatryofmichigan.loriharrison@153418.advancedmd-direct.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 6301008233 | MI | Yes |
Addresses
Primary practice location
20600 Eureka Rd
Suite 819
Taylor, MI 48180-5343
Mailing address
1709 McKinley
Wyandotte, MI 48192-7206
Phone (734) 282-3518
Other providers in Taylor, MI
- Manzoor Haroon
- Michael J Haroutunian
- Courtney Arieal Harper
- Mathew F Harris
- James Milner Harrison
- Karen Marie Harven
- Jennifer Joann Harvey
- Dianne L Hashim-Amerson
- Karen L. Hatch
- Katina Haynes
All providers in Taylor, MI · Clinical Psychologist in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.