Provider Demographics
NPI:1043418726
Name:SAGINAW PSYCHOLOGICAL SERVICES INC.
Entity Type:Organization
Organization Name:SAGINAW PSYCHOLOGICAL SERVICES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:NATHALIE
Authorized Official - Middle Name:
Authorized Official - Last Name:MENENDES
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:989-799-2100
Mailing Address - Street 1:2100 HEMMETER RD
Mailing Address - Street 2:
Mailing Address - City:SAGINAW
Mailing Address - State:MI
Mailing Address - Zip Code:48603-3944
Mailing Address - Country:US
Mailing Address - Phone:989-799-2100
Mailing Address - Fax:989-799-2637
Practice Address - Street 1:2100 HEMMETER RD
Practice Address - Street 2:
Practice Address - City:SAGINAW
Practice Address - State:MI
Practice Address - Zip Code:48603-3944
Practice Address - Country:US
Practice Address - Phone:989-799-2100
Practice Address - Fax:989-799-2637
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-05
Last Update Date:2021-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0915317OtherBCBS OPC PSYCHIATRIST