NPIMap

Organization Active NPI

Lakeside Psychological Services, P.C.

  • Clinical Psychologist
  • Macomb, MI
National Provider Identifier
1427003375
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
6301002887 Issued in MI
Legal business name
LAKESIDE PSYCHOLOGICAL SERVICES, P.C.
Practice address
52759 Woodmill Dr
Macomb, MI 48042-5668
Phone
(586) 677-7860
Fax
(586) 677-7860
NPI assigned
May 22, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Carl Eric Alsterberg, PH.D.NPI 1639123706
Title
Owner
Phone
(586) 677-7860

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X 6301002887 MI Primary

Addresses

Primary practice location

52759 Woodmill Dr
Macomb, MI 48042-5668

Mailing address

52759 Woodmill Dr
Macomb, MI 48042-5668
Phone (586) 677-7860

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1148256000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1427003375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "52759 WOODMILL DR",
            "city": "MACOMB",
            "state": "MI",
            "postal_code": "480425668",
            "telephone_number": "586-677-7860",
            "fax_number": "586-677-7860"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "52759 WOODMILL DR",
            "city": "MACOMB",
            "state": "MI",
            "postal_code": "480425668",
            "telephone_number": "586-677-7860",
            "fax_number": "586-677-7860"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKESIDE PSYCHOLOGICAL SERVICES, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-22",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ALSTERBERG",
        "authorized_official_first_name": "CARL",
        "authorized_official_middle_name": "ERIC",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "586-677-7860",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6301002887",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Macomb, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.