Provider Demographics
NPI:1083763189
Name:PSYCHOLOGICAL EVALUATION AND CONSULTING SERVICES P.C.
Entity Type:Organization
Organization Name:PSYCHOLOGICAL EVALUATION AND CONSULTING SERVICES P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:VERNARD
Authorized Official - Last Name:BARBER
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:248-755-0892
Mailing Address - Street 1:30345 LA BREA CT
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:MI
Mailing Address - Zip Code:48025-1514
Mailing Address - Country:US
Mailing Address - Phone:248-755-8092
Mailing Address - Fax:248-538-8066
Practice Address - Street 1:13998 MERRIMAN RD
Practice Address - Street 2:
Practice Address - City:LIVONIA
Practice Address - State:MI
Practice Address - Zip Code:48154-4259
Practice Address - Country:US
Practice Address - Phone:248-755-0892
Practice Address - Fax:248-538-8066
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301007614103G00000X, 103T00000X, 103TC0700X, 103TC1900X, 103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered103G00000XBehavioral Health & Social Service ProvidersClinical NeuropsychologistGroup - Multi-Specialty
Not Answered103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
Not Answered103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
Not Answered103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounselingGroup - Multi-Specialty
Not Answered103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & AdolescentGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIM91440006Medicare ID - Type UnspecifiedMEDICARE