Anna Priscilla Dematatis, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

6301013211 Issued in MI

Practice address

4572 S Hagadorn Rd Ste 2E
East Lansing, MI 48823-5385

Phone

(512) 619-7748

Fax

(517) 349-3755

NPI assigned

Oct 11, 2006

Last updated

Jun 1, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

Practice roles

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.

• Integrity Counseling Services

  • Social Worker
  • Okemos, MI
  • NPI 1063742583
  NPD (past)

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

{
    "created_epoch": "1160524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685577600000",
    "number": "1619065026",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10",
            "city": "MASON",
            "state": "MI",
            "postal_code": "488540010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4572 S HAGADORN RD STE 2E",
            "city": "EAST LANSING",
            "state": "MI",
            "postal_code": "488235385",
            "telephone_number": "512-619-7748",
            "fax_number": "517-349-3755"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEMATATIS",
        "first_name": "ANNA",
        "middle_name": "PRISCILLA",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-11",
        "last_updated": "2023-06-01",
        "certification_date": "2023-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6301013211",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hannah Joy Dejong, FNP
• Timothy Delaney, LMT,
• Angela M Delo-Miller, RN
• Jeremy Todd Delong
• Vincent Paul Delvalle, ATC
• Hayley Demay, RPH
• Laurel Olivia Demay
• Caylee Dempsey
• Robin Hazard Demuth, MD
• Carrie Alice Denbow, LMSW

• Clinical Psychologist in East Lansing, MI
• Providers in East Lansing, MI by specialty
• Clinical Psychologist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 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.