LIST PSYCHOLOGICAL SERVICES NPI 1124357488

NPI Information

NPI: 1124357488
Provider Name: LIST PSYCHOLOGICAL SERVICES
Classification: Counselor - 101YA0400X
Entity Type: Organization

Specialization: Addiction (Substance Use Disorder)

CLIA Number: 23D2147653

Address:
1600 N MICHIGAN AVE
ROOM 506
SAGINAW, MI
ZIP 48602
Phone: (989) 758-3720
Get Directions

LIST PSYCHOLOGICAL SERVICES is an addiction (substance use disorder) counselor in Saginaw, MI. LIST PSYCHOLOGICAL SERVICES NPI is 1124357488. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

1600 N MICHIGAN AVE
ROOM 506
SAGINAW, MI
ZIP 48602-306
Phone: (989) 758-3720
Fax: (989) 758-3760

The provider's authorized official is Diane R List .
The authorized official title is Chief Executive Officer and has the following contact phone number (989) 672-6160.

The CLIA number assigned to this NPI record is 23D2147653 - other with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 12/16/2009 and was last updated on 12/16/2009.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License State	Primary
1	101Y00000X	Counselor			No
2	101YM0800X	Counselor	Mental Health		No
3	101YP2500X	Counselor	Professional		No
4	103TC0700X	Psychologist	Clinical		No
5	104100000X	Social Worker			No
6	1041C0700X	Social Worker	Clinical		No
7	106H00000X	Marriage & Family Therapist			No
8	101YA0400X	Counselor	Addiction (Substance Use Disorder)	MICHIGAN	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	034530	OTHER	MICHIGAN	VALUE OPTIONS
2	0M38660	MEDICARE UPIN	MICHIGAN
3	0G96288	MEDICARE UPIN	MICHIGAN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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