Individual provider Active NPI

Michelle Shannon Lynch, PSY.D.

  • Clinical Child & Adolescent Psychologist
  • Westminster, CO
National Provider Identifier
1376594820
Registry record updated Feb 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Child & Adolescent PsychologistTaxonomy code 103TC2200X
License
6301012771 Issued in MI
Practice address
9035 Wadsworth Pkwy Ste 2600
Westminster, CO 80021-8627
Phone
(720) 845-2988
Fax
(888) 639-9341
NPI assigned
May 12, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 7, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Child & Adolescent Psychologist 103TC2200X 6301012771 MI Primary

Addresses

Primary practice location

9035 Wadsworth Pkwy Ste 2600
Westminster, CO 80021-8627

Mailing address

9035 Wadsworth Pkwy Ste 2600
Westminster, CO 80021-8627
Phone (248) 808-7681

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20081107000111 MI Practitioner - Clinical Psychologist 8325107253 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6301012771MIMDClinical Child & Adolescent Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Mielke & Weeks, P. C. CurrentSince Oct 9, 2016 Accepting new patients
Ann Sheridan Straky PH.D., P.C. Past Accepting new patients
Wentworth and Associates PC Past Accepting new patients
Michelle S Lynch PSYD PLLC PastSince Feb 11, 2024 Accepting new patients

Locations

1880 Star Batt Dr
Rochester Hills, MI 48309
Phone (248) 289-6817

1880 Star Batt Dr
Bldg 1
Rochester Hills, MI 48309
Phone (248) 375-0834

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1147392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707264000000",
    "number": "1376594820",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9035 WADSWORTH PKWY STE 2600",
            "city": "WESTMINSTER",
            "state": "CO",
            "postal_code": "800218627",
            "telephone_number": "248-808-7681"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9035 WADSWORTH PKWY STE 2600",
            "city": "WESTMINSTER",
            "state": "CO",
            "postal_code": "800218627",
            "telephone_number": "720-845-2988",
            "fax_number": "888-639-9341"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LYNCH",
        "first_name": "MICHELLE",
        "middle_name": "SHANNON",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-05-12",
        "last_updated": "2024-02-07",
        "certification_date": "2024-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "MI",
            "license": "6301012771",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Westminster, CO

Sources for this page

Verify at the official NPI Registry.