Provider Demographics
NPI:1184773368
Name:LANSING PSYCHOLOGICAL ASSOCIATES INC
Entity type:Organization
Organization Name:LANSING PSYCHOLOGICAL ASSOCIATES INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:BILLING SUPERVISOR
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:CARTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:517-337-6545
Mailing Address - Street 1:2001 ABBOT RD
Mailing Address - Street 2:
Mailing Address - City:EAST LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48823-1400
Mailing Address - Country:US
Mailing Address - Phone:517-337-6545
Mailing Address - Fax:517-337-3010
Practice Address - Street 1:2001 ABBOT RD
Practice Address - Street 2:
Practice Address - City:EAST LANSING
Practice Address - State:MI
Practice Address - Zip Code:48823-1400
Practice Address - Country:US
Practice Address - Phone:517-337-6545
Practice Address - Fax:517-337-3010
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-09
Last Update Date:2021-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI037537OtherVALUE OPTIONS PIN #
MI7509108750OtherBLUE CROSS FACILITY #
MI7509108750OtherBLUE CROSS FACILITY #
MI0C36456Medicare ID - Type UnspecifiedGROUP # FOR PHD