Provider Demographics
NPI:1407941677
Name:PSYCHOLOGICAL CONSULTANTS OF MICHIGAN, P.C.
Entity Type:Organization
Organization Name:PSYCHOLOGICAL CONSULTANTS OF MICHIGAN, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:
Authorized Official - Last Name:ANDERT
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:269-968-2811
Mailing Address - Street 1:7 HERITAGE OAK LN STE 1
Mailing Address - Street 2:
Mailing Address - City:BATTLE CREEK
Mailing Address - State:MI
Mailing Address - Zip Code:49015-4283
Mailing Address - Country:US
Mailing Address - Phone:269-967-1311
Mailing Address - Fax:269-968-2651
Practice Address - Street 1:7 HERITAGE OAK LN STE 1
Practice Address - Street 2:
Practice Address - City:BATTLE CREEK
Practice Address - State:MI
Practice Address - Zip Code:49015-4283
Practice Address - Country:US
Practice Address - Phone:269-967-1311
Practice Address - Fax:269-968-2651
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-04
Last Update Date:2022-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
No103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & AdolescentGroup - Single Specialty
No104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI680A39524OtherDR. ANDERT BLUE CROSS ID
MI1705289-21Medicaid
MI321748OtherVALUE OPTIONS PROVIDER ID
MI20604OtherBLUE CROSS FACILITY ID
MI343921OtherHEALTH NET ID#
MI7609153570OtherBLUE CHOICE ID#
MI0N91190Medicare ID - Type UnspecifiedMEDICARE CSW GROUP