Circle of Life Psychological Services, PC

Primary specialty

Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X

Legal business name

CIRCLE OF LIFE PSYCHOLOGICAL SERVICES, PC

Practice address

1700 W Big Beaver Rd Ste 200
Troy, MI 48084-3524

Phone

(248) 420-6742

Fax

(248) 243-8668

NPI assigned

Jan 11, 2019

Organization subpart

No

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

Authorized official

Name

Marianne M. Key-Carniak, MS, LLP, LLMFT

Title

Owner

Phone

(248) 420-6742

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Crystal Gibson, TLLP

  • Psychologist
  • Sterling Heights, MI
  • NPI 1114382595
  NPD (past)

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

{
    "created_epoch": "1547164800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1547164800000",
    "number": "1851865968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 LANGE DR",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480984667",
            "telephone_number": "248-420-6742"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 W BIG BEAVER RD STE 200",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480843524",
            "telephone_number": "248-420-6742",
            "fax_number": "248-243-8668"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CIRCLE OF LIFE PSYCHOLOGICAL SERVICES, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-01-11",
        "last_updated": "2019-01-11",
        "status": "A",
        "authorized_official_last_name": "KEY-CARNIAK",
        "authorized_official_first_name": "MARIANNE",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "248-420-6742",
        "authorized_official_credential": "MS, LLP, LLMFT"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sara Lynn Chung, APRN
• Kelli Ann Ciaverella, BEHAVIOR TECHNICIAN
• Andrew Stephen Ciennik, MD
• Carol Ciesielski, P.T.
• Rene Kimberly Cipponeri, RDH
• Andrea Marie Cirrito, PA
• Jerome V Ciullo, MD
• Abigail Jane Cizek, PA-C
• David Claeys
• Gary Jonathan Clague, DDS

• Adult Mental Health Clinic/Center in Troy, MI
• Providers in Troy, MI by specialty
• Adult Mental Health Clinic/Center in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2019; 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.