Lake Michigan Neuropsychology PLLC

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

Legal business name

LAKE MICHIGAN NEUROPSYCHOLOGY PLLC

Practice address

900 Victors Way Ste 175
Ann Arbor, MI 48108-5224

Phone

(734) 328-1991

Fax

(734) 480-8987

NPI assigned

Apr 4, 2023

Organization subpart

No

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

Authorized official

Name

Eduardo Montoya

Title

Owner

Phone

(734) 328-1991

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1680566400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1680566400000",
    "number": "1699470039",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 VICTORS WAY STE 175",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481085224",
            "telephone_number": "734-328-1991",
            "fax_number": "734-480-8987"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 VICTORS WAY STE 175",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481085224",
            "telephone_number": "734-328-1991",
            "fax_number": "734-480-8987"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKE MICHIGAN NEUROPSYCHOLOGY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-04-04",
        "last_updated": "2023-04-04",
        "certification_date": "2023-04-04",
        "status": "A",
        "authorized_official_last_name": "MONTOYA",
        "authorized_official_first_name": "EDUARDO",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "734-328-1991"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Suzette Damarlie Laing, DDS, PHD
• Timothy J Laing, MD
• Molly F Laird McMullen, MD
• Melissa Laird
• Christina Stark Laitner, PH.D.
• Allison Josephine Lake, PH.D.
• Alvin E. Lake, PHD
• Matthew John Lake, MD
• Tamar Lake, MD
• Hamza Mohammed Lakhani, PA-C

• Clinical Psychologist in Ann Arbor, MI
• Providers in Ann Arbor, MI by specialty
• Clinical Psychologist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2023; 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.