Psygenics Inc
Organization Active NPI Clinical Social Worker · Dearborn, MI
NPI 1669736104 · NPPES record last updated Jun 4, 2024
Key facts
- NPI
- 1669736104
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Clinical Social Worker 1041C0700X
- Legal business name
- PSYGENICS INC
- Practice address
- 1 Parklane Blvd Ste 200E
Dearborn, MI 48126-2400 - Phone
- (313) 846-2606
- NPI assigned
- Jun 29, 2012
- Organization subpart
- No
Authorized official
- Name
- Mrs. Judy Hinson
- Title
- Business/HR Director
- Phone
- (586) 204-5560
Practitioners 111
-
Mona M Baydoun I, MA,LLPC
-
Michael Watts, M.D.
-
Jaime Dawdy, MA, CCC-SLP
-
Amie Dawn Detharidge, OTRL
-
Kira Whitney Burnett, LMSW
-
Lajean Partmon, LLMSW
-
Marykelly Wallace, MOTR/L
-
Chitra Lakshumanan, M.A., CCC-SLP
-
Sandra Duque, LMSW
-
Faith Adams, BSW
-
Samantha Boutin, LMSW
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MI
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20150831002063 | MI | Part B Supplier - Clinic/Group Practice | 9436465820 |
Receives reassigned benefits from 14 practitioners Practice locations: Dearborn, MI; Trenton, MI; Roseville, MI; Detroit, MI |
National Provider Directory
Locations
6425 Schaefer Rd
Ste 2
Dearborn, MI 48126
Phone (313) 846-2606
7800 W Outer Dr
Fl 3
Detroit, MI 48235
11000 W McNichols Rd
Ste 320
Detroit, MI 48221
Phone (313) 340-4442
7800 W Outer Dr
Ste 300
Detroit, MI 48235
Phone (313) 283-5135
27085 Gratiot Ave
Ste 107
Roseville, MI 48066
Phone (586) 285-5361
27085 Gratiot Ave
Ste 101
Roseville, MI 48066
Phone (586) 204-5560
1660 Fort St
Trenton, MI 48183
Phone (734) 304-4159
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor |
101YM0800X | |||
| Behavior Analyst |
103K00000X | |||
| Psychologist |
103T00000X | |||
| Clinical Psychologist |
103TC0700X | |||
| Counseling Psychologist |
103TC1900X | |||
| Clinical Child & Adolescent Psychologist |
103TC2200X | |||
| Clinical Social Worker |
1041C0700X | Yes | ||
| Community Health Registered Nurse |
163WC1500X | |||
| Home Health Registered Nurse |
163WH0200X | |||
| Psychiatric/Mental Health Registered Nurse |
163WP0808X | |||
| Psychiatry Physician |
2084P0800X | |||
| Occupational Therapy Assistant |
224Z00000X | |||
| Occupational Therapist |
225X00000X | |||
| Speech-Language Pathologist |
235Z00000X | |||
| Community/Behavioral Health Agency | 251S00000X | MI |
Addresses
Primary practice location
1 Parklane Blvd Ste 200E
Dearborn, MI 48126-2400
Mailing address
27085 Gratiot Ave Ste 101
Roseville, MI 48066-2984
Phone (586) 204-5560
Other practice location 1
1660 Fort St
Trenton, MI 48183-2003
Phone (734) 304-4159
Other providers in Dearborn, MI
- Dasheika Jatone Provost
- Valerie Przywara
- Psychology Talk
- Psychplus Associates of Michigan, PLLC
- Psychplus Medical Associates of Michigan, PLLC
- Jeffrey Eugene Puccio
- Ashley Pudelek
- Pulmonary & Sleep Medicine Center PC
- Pulmonary Specialists of Michigan, PC
- Pulse Physical Therapy LLC
All providers in Dearborn, MI · Clinical Social Worker in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 4, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.