Adam R Pasciak, PH.D., LP

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

6301015095 Issued in MI

Practice address

3604 Clarkston Rd
Clarkston, MI 48348-5215

Phone

(248) 595-9969

Fax

(248) 814-0361

NPI assigned

Mar 23, 2011

Last updated

Dec 21, 2023By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 7

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

Specialty

Clinical Psychologist

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Lake Orion Counseling CenterGroup PAC ID 3870717838, 5 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Lake Orion Counseling Center

  • Psychologist
  • Clarkston, MI
  • NPI 1255759486
  Medicare reassignment Care Compare group NPD Authorized official

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

{
    "created_epoch": "1300838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703116800000",
    "number": "1548569049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3604 CLARKSTON RD",
            "city": "CLARKSTON",
            "state": "MI",
            "postal_code": "483485215",
            "telephone_number": "248-595-9969",
            "fax_number": "248-814-0361"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3604 CLARKSTON RD",
            "city": "CLARKSTON",
            "state": "MI",
            "postal_code": "483485215",
            "telephone_number": "248-595-9969",
            "fax_number": "248-814-0361"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PASCIAK",
        "first_name": "ADAM",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "PH.D., LP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-03-23",
        "last_updated": "2023-12-21",
        "certification_date": "2021-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6301015095",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS TRUST",
            "identifier": "750910402",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSFED",
            "identifier": "750910402",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "032919",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS MICHIGAN",
            "identifier": "750910402",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS CHRYSLER",
            "identifier": "750910402",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS OUT OF STATE",
            "identifier": "750910402",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHPLUS OF MICHIGAN",
            "identifier": "XX19153",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Matthew M Pambid, MSW, LMSW, ACSW
• Bonnie Jo Parker, PSY.D.
• Baeli Aletta Partridge, BEHAVIOR TECHNICIAN
• Skye K Partridge, BEHAVIOR TECHNICIAN
• Partwo Inc (Medcenter Pharmacy)
• Crystal R. Pasciak, MS, LPC
• Colleen Marie Pascoe, OT
• Anthony Richard Pasquale, DPT
• Bhupendranath Galal Patel, M.D.
• Hardik Yogendrabhai Patel

• Clinical Psychologist in Clarkston, MI
• Providers in Clarkston, MI by specialty
• Clinical Psychologist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.