NPIMap

Organization Active NPI

East Lansing Psychological Services PLLC

  • Psychologist
  • East Lansing, MI
National Provider Identifier
1689015703
Registry record updated Jul 17, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
6301009001 Issued in MI
Legal business name
EAST LANSING PSYCHOLOGICAL SERVICES PLLC
Practice address
121 Burcham Dr
East Lansing, MI 48823-2703
Phone
(517) 420-1377
NPI assigned
Jul 17, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2013

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

Authorized official

Name
Eileen Hathaway, LLP
Title
Owner
Phone
(517) 420-1377

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103T00000X 6301009001 MI Primary

Addresses

Primary practice location

121 Burcham Dr
East Lansing, MI 48823-2703

Mailing address

PO Box 10
Mason, MI 48854-0010
Phone (517) 676-9788

National Provider Directory

National Provider Directory

Locations

121 Burcham Dr
East Lansing, MI 48823
Phone (517) 420-1377

NPI Registry JSON

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

{
    "created_epoch": "1374019200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1374019200000",
    "number": "1689015703",
    "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",
            "telephone_number": "517-676-9788",
            "fax_number": "517-676-3438"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 BURCHAM DR",
            "city": "EAST LANSING",
            "state": "MI",
            "postal_code": "488232703",
            "telephone_number": "517-420-1377"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAST LANSING PSYCHOLOGICAL SERVICES PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-07-17",
        "last_updated": "2013-07-17",
        "status": "A",
        "authorized_official_last_name": "HATHAWAY",
        "authorized_official_first_name": "EILEEN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "517-420-1377",
        "authorized_official_credential": "LLP"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": "MI",
            "license": "6301009001",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Lansing, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.