Melissa Renee Bogdalek, PSYD, LLP
Individual provider Active NPI Clinical Psychologist · Walled Lake, MI
NPI 1992269633 · NPPES record last updated Dec 4, 2025
Key facts
- NPI
- 1992269633
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Psychologist 103TC0700X
- License
- 6361008099 (MI)
- Practice address
- 100 N Pond Dr Ste a
Walled Lake, MI 48390-3079 - Phone
- (248) 755-5874
- Fax
- (866) 607-5280
- NPI assigned
- Jan 28, 2019
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist |
103TC0700X | 6361008099 | MI | Yes |
Addresses
Primary practice location
100 N Pond Dr Ste a
Walled Lake, MI 48390-3079
Mailing address
100 N Pond Dr Ste a
Walled Lake, MI 48390-3079
Phone (248) 755-5874
Other providers in Walled Lake, MI
- Satabdi Banerjee
- Mariyam Batool
- Tainara Benassi Lourenco
- Courtney Marie Bender
- Elizabeth Marie Blomquist
- Bormans Inc
- Brandon a West DPM JD PLLC
- Javon M Brown
- Barbra Byrd
- Jeffrie Kon Cape
All providers in Walled Lake, MI · Clinical Psychologist in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 4, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.