NPIMap

Organization Active NPI

Professional Psychological & Rehabilitation Services

  • Clinical Psychologist
  • Lansing, MI
National Provider Identifier
1972625424
Registry record updated Oct 17, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
6301003971 Issued in MI
Legal business name
PROFESSIONAL PSYCHOLOGICAL & REHABILITATION SERVICES
Practice address
3815 W St Joseph Hwy, Suite A101
Lansing, MI 48917
Phone
(517) 321-5900
Fax
(517) 321-5945
NPI assigned
Apr 4, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2017

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

Authorized official

Name
Dr. Hilton T Thomas, PH.D.
Title
Executive Director
Phone
(517) 321-5900

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC0700X 6301003971 MI Primary
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X 6801063438 MI

Addresses

Primary practice location

3815 W St Joseph Hwy, Suite A101
Lansing, MI 48917

Mailing address

3815 W St Joseph Hwy, Suite A101
Lansing, MI 48917
Phone (517) 321-5900

Other identifiers 1

IdentifierTypeStateIssuer
OC34604MedicaidMI

National Provider Directory

National Provider Directory

Locations

302 S Waverly Rd
Ste 1
Lansing, MI 48917
Phone (517) 321-5900

Practitioners & affiliated clinicians

Practitioners 7

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

NPI Registry JSON

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

{
    "created_epoch": "1175644800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1508198400000",
    "number": "1972625424",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3815 W ST JOSEPH HWY, SUITE A101",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "48917",
            "telephone_number": "517-321-5900",
            "fax_number": "517-321-5945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3815 W ST JOSEPH HWY, SUITE A101",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "48917",
            "telephone_number": "517-321-5900",
            "fax_number": "517-321-5945"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROFESSIONAL PSYCHOLOGICAL & REHABILITATION SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-04",
        "last_updated": "2017-10-17",
        "status": "A",
        "authorized_official_last_name": "THOMAS",
        "authorized_official_first_name": "HILTON",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "517-321-5900",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6301003971",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801063438",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "OC34604",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lansing, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2017; 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.