Individual provider Active NPI

Brian B Lehky, PH.D.

  • Clinical Psychologist
  • Petoskey, MI
National Provider Identifier
1528113826
Registry record updated Dec 6, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
6301010367 Issued in MI
Practice address
2202 Mitchell Park Dr
Unit 5
Petoskey, MI 49770-8897
Phone
(231) 439-5299
Fax
(231) 439-5272
NPI assigned
Jan 24, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 6, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 6301010367 MI Primary

Addresses

Primary practice location

2202 Mitchell Park Dr
Unit 5
Petoskey, MI 49770-8897

Mailing address

2202 Mitchell Park Dr
Unit 5
Petoskey, MI 49770-8897
Phone (231) 439-5299

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
I20110706000195 MI Practitioner - Clinical Psychologist 8022296532 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1523 US Hwy 131
Suite D
Petoskey, MI 49770-8891
Phone (231) 439-5299

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
6301010367MIMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Brian B Lehky PHD PC Clinical CurrentSince Jun 20, 2011 Accepting new patients
Psychnorth PastSince Jan 1, 2016 Accepting new patients

Locations

2202 Mitchell Park Dr
Ste 5
Petoskey, MI 49770
Phone (231) 348-5018

1523 US Highway 131
Ste D
Petoskey, MI 49770
Phone (231) 439-5299

1523 US Highway 131
Ste H
Petoskey, MI 49770
Phone (231) 439-5299

Organizations & group practices 2

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": "1169596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1449360000000",
    "number": "1528113826",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2202 MITCHELL PARK DR",
            "address_2": "UNIT 5",
            "city": "PETOSKEY",
            "state": "MI",
            "postal_code": "497708897",
            "telephone_number": "231-439-5299",
            "fax_number": "231-439-5272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2202 MITCHELL PARK DR",
            "address_2": "UNIT 5",
            "city": "PETOSKEY",
            "state": "MI",
            "postal_code": "497708897",
            "telephone_number": "231-439-5299",
            "fax_number": "231-439-5272"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEHKY",
        "first_name": "BRIAN",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-24",
        "last_updated": "2015-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6301010367",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Petoskey, MI

Sources for this page

Verify at the official NPI Registry.