Provider Demographics
NPI:1558577502
Name:COMPREHENSIVE HEARING CLINIC
Entity Type:Organization
Organization Name:COMPREHENSIVE HEARING CLINIC
Other - Org Name:THE HEARING CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LORI
Authorized Official - Middle Name:K
Authorized Official - Last Name:LINGO
Authorized Official - Suffix:
Authorized Official - Credentials:MED, CCC-A
Authorized Official - Phone:810-225-2205
Mailing Address - Street 1:2300 GENOA BUSINESS PARK DR
Mailing Address - Street 2:SUITE 130
Mailing Address - City:BRIGHTON
Mailing Address - State:MI
Mailing Address - Zip Code:48114-7367
Mailing Address - Country:US
Mailing Address - Phone:810-225-2205
Mailing Address - Fax:810-225-2209
Practice Address - Street 1:24001 ORCHARD LAKE RD
Practice Address - Street 2:SUITE 170
Practice Address - City:FARMINGTON
Practice Address - State:MI
Practice Address - Zip Code:48336-2555
Practice Address - Country:US
Practice Address - Phone:810-225-2205
Practice Address - Fax:810-225-2209
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI16000209231H00000X
MI1601000209231HA2400X, 231HA2500X, 237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Multi-Specialty
Not Answered231HA2400XSpeech, Language and Hearing Service ProvidersAudiologistAssistive Technology PractitionerGroup - Multi-Specialty
Not Answered231HA2500XSpeech, Language and Hearing Service ProvidersAudiologistAssistive Technology SupplierGroup - Multi-Specialty
Not Answered237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid FitterGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI080253OtherHAP PROVIDER NUMBER
MI11637061OtherCAQH
MI=========OtherMESSA
MI=========OtherAETNA
MI=========OtherPPOM
MI11637061OtherCAQH