NPIMap

Organization Active NPI

Senior Psychiatric Services of Mi, PLLC

  • Psychiatry Physician
  • Livonia, MI
National Provider Identifier
1336152933
Registry record updated Jan 24, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
SENIOR PSYCHIATRIC SERVICES OF MI, PLLC
Practice address
38807 Ann Arbor Rd Ste 7
Livonia, MI 48150-3896
Phone
(734) 953-6734
Fax
(734) 953-6738
NPI assigned
Aug 14, 2006
Last updated
Jan 24, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2019

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

Authorized official

Name
Debra Koelzer, PA-CNPI 1154343465
Title
Managing Partner
Phone
(734) 634-9965

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X
Clinical Psychologist 103TC0700X
Psychiatry Physician 2084P0800X Primary

Addresses

Primary practice location

38807 Ann Arbor Rd Ste 7
Livonia, MI 48150-3896

Mailing address

38807 Ann Arbor Rd Ste 7
Livonia, MI 48150-3896
Phone (734) 953-6734

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 15

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 15

NPI Registry JSON

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

{
    "created_epoch": "1155513600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1548288000000",
    "number": "1336152933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "38807 ANN ARBOR RD STE 7",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481503896",
            "telephone_number": "734-953-6734",
            "fax_number": "734-953-6738"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "38807 ANN ARBOR RD STE 7",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481503896",
            "telephone_number": "734-953-6734",
            "fax_number": "734-953-6738"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SENIOR PSYCHIATRIC SERVICES OF MI, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-14",
        "last_updated": "2019-01-24",
        "status": "A",
        "authorized_official_last_name": "KOELZER",
        "authorized_official_first_name": "DEBRA",
        "authorized_official_title_or_position": "MANAGING PARTNER",
        "authorized_official_telephone_number": "734-634-9965",
        "authorized_official_credential": "PA-C"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Livonia, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2019; 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.