Psychological and Consultation Services PC

Primary specialty

PsychologistTaxonomy code 103T00000X

Legal business name

PSYCHOLOGICAL AND CONSULTATION SERVICES PC

Practice address

4123 Okemos Rd Ste 15
Okemos, MI 48864-2818

Phone

(517) 336-7366

Fax

(517) 336-0808

NPI assigned

Dec 20, 2006

Last updated

Jul 6, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Priscilla Wade, PH.D.NPI 1871650291

Title

Licensed Psychologist, President

Phone

(517) 336-7366

Specialties & licenses 1

Addresses

Other identifiers 11

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Practitioners 3

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.

• Priscilla Wade, PH.D

  • Psychologist
  • Okemos, MI
  • NPI 1871650291
  Medicare reassignment NPD Authorized official
• Soyoung Jung

  • Clinical Psychologist
  • Okemos, MI
  • NPI 1851180129
  NPD
• Jennifer Smith Allswede, PHD

  • Psychologist
  • East Lansing, MI
  • NPI 1891842001
  NPD (past)

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

{
    "created_epoch": "1166572800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1593993600000",
    "number": "1407910854",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4455",
            "city": "EAST LANSING",
            "state": "MI",
            "postal_code": "488264455",
            "telephone_number": "517-336-7366",
            "fax_number": "517-336-0808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4123 OKEMOS RD STE 15",
            "city": "OKEMOS",
            "state": "MI",
            "postal_code": "488642818",
            "telephone_number": "517-336-7366",
            "fax_number": "517-336-0808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PSYCHOLOGICAL AND CONSULTATION SERVICES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-20",
        "last_updated": "2020-07-06",
        "certification_date": "2020-07-06",
        "status": "A",
        "authorized_official_last_name": "WADE",
        "authorized_official_first_name": "PRISCILLA",
        "authorized_official_title_or_position": "LICENSED PSYCHOLOGIST, PRESIDENT",
        "authorized_official_telephone_number": "517-336-7366",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COFINITY",
            "identifier": "1871650291",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BEACON HEALTH OPTIONS INC",
            "identifier": "A185414",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MCLAREN",
            "identifier": "R1016708",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "1871650291",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "1871650291",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PARAIRIE STATES ENTERPRISES INC",
            "identifier": "1871650291",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICIAN HEALTH PLAN",
            "identifier": "200000006054",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM",
            "identifier": "68OC346780",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PRIORITY HEALTH",
            "identifier": "900080140",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "B;UE CROSS TRUST",
            "identifier": "11291411",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BANKER'S FIDELITY LIFE INSURANCE",
            "identifier": "1871650291",
            "state": "MI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "5173360808",
            "affiliation": "N",
            "endpointDescription": "Electronic Fax",
            "address_1": "4123 Okemos Rd Ste 15",
            "city": "Okemos",
            "state": "MI",
            "country_code": "US",
            "postal_code": "488642818",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Psychologist in Okemos, MI
• Providers in Okemos, MI by specialty
• Psychologist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.