Provider Demographics
NPI:1295959005
Name:PSYCHOLOGICAL SERVICES
Entity type:Organization
Organization Name:PSYCHOLOGICAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CAROL
Authorized Official - Middle Name:L
Authorized Official - Last Name:HATCHER
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:517-332-3870
Mailing Address - Street 1:3448 E LAKE LANSING RD
Mailing Address - Street 2:
Mailing Address - City:EAST LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48823-1511
Mailing Address - Country:US
Mailing Address - Phone:517-332-3870
Mailing Address - Fax:517-332-9247
Practice Address - Street 1:3448 E LAKE LANSING RD
Practice Address - Street 2:
Practice Address - City:EAST LANSING
Practice Address - State:MI
Practice Address - Zip Code:48823-1511
Practice Address - Country:US
Practice Address - Phone:517-332-3870
Practice Address - Fax:517-332-9247
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MILE002799103T00000X
MICH007419103T00000X
MIKL064381104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty
Not Answered104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MICH007419OtherCAROL HATCHER'S LIC#
MILE012182OtherLYNNE EMERSON LIC#
MIKL064381OtherKATHY LARKEY-GREEN'S LIC#
MICH007419OtherCAROL HATCHER'S LIC#