NPIMap

Organization Active NPI

Psychological Professional Services

  • Clinical Psychologist
  • Clinton Township, MI
National Provider Identifier
1518329671
Registry record updated Mar 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
6301011383 Issued in MI
Legal business name
PSYCHOLOGICAL PROFESSIONAL SERVICES
Practice address
38800 Garfield Rd Ste 100
Clinton Township, MI 48038-6619
Phone
(586) 231-0306
Fax
(586) 231-0307
NPI assigned
Mar 27, 2016
Last updated
Mar 14, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2022

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

Authorized official

Name
Dr. Cheryl Ann Lewis, PHD. LLPNPI 1568658623
Title
Clinical Director
Phone
(586) 231-0306

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 6301011383 MI Primary

Addresses

Primary practice location

38800 Garfield Rd Ste 100
Clinton Township, MI 48038-6619

Mailing address

38800 Garfield Rd Ste 100
Clinton Township, MI 48038-6619
Phone (586) 231-0306

Other practice location 1

2425 S Linden Rd Ste D118
Flint, MI 48532-5481
Phone (810) 820-6656

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200108003135 MI Part B Supplier - Clinic/Group Practice 5799110334 Receives reassigned benefits from 2 practitioners
Practice locations: Clinton Township, MI; Flint, MI

National Provider Directory

National Provider Directory

Locations

42477 Garfield Rd
Clinton Twp, MI 48038
Phone (586) 231-0306

2425 S Linden Rd
Ste D118
Flint, MI 48532
Phone (248) 731-8045

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": "1459036800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1647216000000",
    "number": "1518329671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "38800 GARFIELD RD STE 100",
            "city": "CLINTON TOWNSHIP",
            "state": "MI",
            "postal_code": "480386619",
            "telephone_number": "586-231-0306",
            "fax_number": "586-231-0307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "38800 GARFIELD RD STE 100",
            "city": "CLINTON TOWNSHIP",
            "state": "MI",
            "postal_code": "480386619",
            "telephone_number": "586-231-0306",
            "fax_number": "586-231-0307"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2425 S Linden Rd Ste D118",
            "address_purpose": "LOCATION",
            "city": "Flint",
            "state": "MI",
            "postal_code": "485325481",
            "country_code": "US",
            "telephone_number": "810-820-6656",
            "fax_number": "586-231-0307",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PSYCHOLOGICAL PROFESSIONAL SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-27",
        "last_updated": "2022-03-14",
        "certification_date": "2022-03-14",
        "status": "A",
        "authorized_official_last_name": "LEWIS",
        "authorized_official_first_name": "CHERYL",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "586-231-0306",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD. LLP"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6301011383",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clinton Township, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2022; 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.