Life Line Psychiatric Services

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

4301405636 Issued in MI

Legal business name

LIFE LINE PSYCHIATRIC SERVICES

Practice address

25501 Van Dyke Ave
Center Line, MI 48015-1824

Phone

(586) 755-8911

NPI assigned

Nov 15, 2013

Organization subpart

No

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

Authorized official

Name

Wladimir Zarski, M.D.

Title

Owner

Phone

(586) 755-8911

Specialties & licenses 1

Addresses

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/13320/brand/1/csg/1/fhir/r4

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jaclyn Hamlin, M.S.C.P, TLLP

  • Clinical Psychologist
  • Center Line, MI
  • NPI 1821460270
  NPD (past)
• Tynise La'Shaie Penn, N.P.

  • Nurse Practitioner
  • Southfield, MI
  • NPI 1073841011
  NPD (past)
• Chalichama A..N Rao, M.D

  • Psychiatry Physician
  • Saginaw, MI
  • NPI 1003908054
  NPD (past)
• Katherine Anne Zarski, RN

  • Registered Nurse
  • Center Line, MI
  • NPI 1891196713
  NPD (past)

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

{
    "created_epoch": "1384473600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1384473600000",
    "number": "1285064063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11456 MEADOWBROOK DR",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480936554",
            "telephone_number": "586-558-0053"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25501 VAN DYKE AVE",
            "city": "CENTER LINE",
            "state": "MI",
            "postal_code": "480151824",
            "telephone_number": "586-755-8911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFE LINE PSYCHIATRIC SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-11-15",
        "last_updated": "2013-11-15",
        "status": "A",
        "authorized_official_last_name": "ZARSKI",
        "authorized_official_first_name": "WLADIMIR",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "586-755-8911",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MI",
            "license": "4301405636",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jamie Lemke, AGACNP-BC
• Danielle Lewis
• Monica Lewis
• Sandra Lewis
• Life 180
• Angelica Lindaman
• David Macon, DO
• Gorgina A Makram
• Laurence Manteuffel, D.C.
• Mark Manteuffel, D.C.

• Psychiatry Physician in Center Line, MI
• Providers in Center Line, MI by specialty
• Psychiatry Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2013; 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.