Lakeshore Psychology, PLLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

6301009500 Issued in MI

Legal business name

LAKESHORE PSYCHOLOGY, PLLC

Practice address

1325 E Sherman Blvd
Muskegon, MI 49444-1813

Phone

(231) 737-8446

Fax

(231) 737-0510

NPI assigned

Jan 30, 2008

Organization subpart

No

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

Authorized official

Name

Lori Diana Milan, PH.D.

Title

Sole Member

Phone

(616) 502-9064

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1201651200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1201651200000",
    "number": "1922285113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17215 ROLLING DUNES DR",
            "city": "WEST OLIVE",
            "state": "MI",
            "postal_code": "494609512",
            "telephone_number": "616-502-9064",
            "fax_number": "616-844-5099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1325 E SHERMAN BLVD",
            "city": "MUSKEGON",
            "state": "MI",
            "postal_code": "494441813",
            "telephone_number": "231-737-8446",
            "fax_number": "231-737-0510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKESHORE PSYCHOLOGY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-30",
        "last_updated": "2008-01-30",
        "status": "A",
        "authorized_official_last_name": "MILAN",
        "authorized_official_first_name": "LORI",
        "authorized_official_middle_name": "DIANA",
        "authorized_official_title_or_position": "SOLE MEMBER",
        "authorized_official_telephone_number": "616-502-9064",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "MI",
            "license": "6301009500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lakeshore Home Health Care Services, Inc.
• Lakeshore Imaging Consultants, PLC
• Lakeshore Massage Therapy Inc
• Lakeshore Medical & Home Health Supply Corporation
• Lakeshore Professional LLC
• Lakeshore Rehabilitation Center PC
• Lakeshore Speech Associates
• Lakewinds Chiropractic Center PLC
• Amy Lalone, LBSW
• Jenna Paparella Lamadline, LLMSW

• Community/Behavioral Health Agency in Muskegon, MI
• Providers in Muskegon, MI by specialty
• Community/Behavioral Health Agency in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2008; 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.