Individual provider Active NPI

Stephen A. Lazar, PH.D.

  • Clinical Psychologist
  • Battle Creek, MI
National Provider Identifier
1861444754
Registry record updated Aug 23, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
6301003002 Issued in MI
Practice address
211 Capital Ave NE
Battle Creek, MI 49017
Phone
(269) 962-2722
Fax
(269) 964-8484
NPI assigned
May 17, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 23, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 6301003002 MI Primary

Addresses

Primary practice location

211 Capital Ave NE
Battle Creek, MI 49017

Mailing address

211 Capital Ave NE
Battle Creek, MI 49017-3926
Phone (269) 962-2722

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20040422000142 MI Practitioner - Clinical Psychologist 3274529623 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
6301003002MIMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Lazar Psychological Services, LTD Clinical CurrentSince Jul 26, 1985 Accepting new patients
Kalamazoo Anesthesiology P C Past Accepting new patients

Locations

211 Capital Ave NE
Battle Creek, MI 49017
Phone 2699622722 ext. 17

7920 Kirkland Ct
Portage, MI 49024
Phone (269) 345-0669

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1147824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534982400000",
    "number": "1861444754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 CAPITAL AVE NE",
            "city": "BATTLE CREEK",
            "state": "MI",
            "postal_code": "490173926",
            "telephone_number": "269-962-2722",
            "fax_number": "269-964-8484"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 CAPITAL AVE NE",
            "city": "BATTLE CREEK",
            "state": "MI",
            "postal_code": "49017",
            "telephone_number": "269-962-2722",
            "fax_number": "269-964-8484"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAZAR",
        "first_name": "STEPHEN",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-17",
        "last_updated": "2018-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6301003002",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Battle Creek, MI

Sources for this page

Verify at the official NPI Registry.