NPIMap

Organization Active NPI

Eastern Michigan University

Doing business as Counseling and Psychological Services

  • Psychiatry Physician
  • Ypsilanti, MI
National Provider Identifier
1245605625
Registry record updated Jul 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
EASTERN MICHIGAN UNIVERSITY
Doing business as
Counseling and Psychological Services
Practice address
1075 North Huron River Drive
Ypsilanti, MI 48197
Phone
(734) 487-1118
Fax
(734) 481-0050
NPI assigned
Dec 10, 2015
Last updated
Jul 29, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2022

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

Authorized official

Name
Lisa Lauterbach, PH.D.
Title
Director
Phone
(734) 487-1118

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X NU
Clinical Social Worker 1041C0700X NU
Psychiatry Physician 2084P0800X NU Primary

Addresses

Primary practice location

1075 North Huron River Drive
Ypsilanti, MI 48197

Mailing address

1075 North Huron River Drive
Ypsilanti, MI 48197
Phone (734) 487-1118

Other names 1

  • Counseling and Psychological Services Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Eastern Michigan University7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

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

Locations

1075 N Huron River Dr
Ypsilanti, MI 48197
Phone (734) 487-1118

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1449705600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1659052800000",
    "number": "1245605625",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1075 NORTH HURON RIVER DRIVE",
            "city": "YPSILANTI",
            "state": "MI",
            "postal_code": "48197",
            "telephone_number": "734-487-1118",
            "fax_number": "734-481-0050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1075 NORTH HURON RIVER DRIVE",
            "city": "YPSILANTI",
            "state": "MI",
            "postal_code": "48197",
            "telephone_number": "734-487-1118",
            "fax_number": "734-481-0050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EASTERN MICHIGAN UNIVERSITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-12-10",
        "last_updated": "2022-07-29",
        "certification_date": "2022-07-29",
        "status": "A",
        "authorized_official_last_name": "LAUTERBACH",
        "authorized_official_first_name": "LISA",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "734-487-1118",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Counseling and Psychological Services",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Counseling and Psychological Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Ypsilanti, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2022; 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.