| Comprehensive Psychological Services Pc | |
|
2720 E Lansing Dr East Lansing MI 48823-7754 | |
| (517) 337-2900 | |
| Not Available |
| Full Name | Comprehensive Psychological Services Pc |
|---|---|
| Speciality | Clinic/Center |
| Location | 2720 E Lansing Dr, East Lansing, Michigan |
| Authorized Official Name and Position | John Keith Ostien (DIRECTOR) |
| Authorized Official Contact | 5173372900 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Comprehensive Psychological Services Pc 2720 E Lansing Dr East Lansing MI 48823-7754 Ph: (517) 337-2900 | Comprehensive Psychological Services Pc 2720 E Lansing Dr East Lansing MI 48823-7754 Ph: (517) 337-2900 |
| NPI Number | 1376759639 |
|---|---|
| Provider Enumeration Date | 05/15/2007 |
| Last Update Date | 08/02/2023 |
| Certification Date | 08/02/2023 |
| Medicare PECOS PAC ID | 6800805060 |
|---|---|
| Medicare Enrollment ID | O20060417000300 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376759639 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Stephen M Cottrell |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1700982758 PECOS PAC ID: 8426009176 Enrollment ID: I20050210000060 |
| Provider Name | John Keith Ostien |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1063518017 PECOS PAC ID: 6204845464 Enrollment ID: I20060418000011 |
| Provider Name | Maryanne K Boltz |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1770689721 PECOS PAC ID: 2264533603 Enrollment ID: I20070730000015 |
| Provider Name | Carol C Laub |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1407952450 PECOS PAC ID: 7315028438 Enrollment ID: I20080115000474 |
| Provider Name | Richard Dombrowski |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1750455226 PECOS PAC ID: 6608055728 Enrollment ID: I20110121000392 |
| Provider Name | Timothy L Goth-owens |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1962508911 PECOS PAC ID: 4486898566 Enrollment ID: I20130911000029 |
| Provider Name | Jonathan D Shy |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1437337417 PECOS PAC ID: 0749415453 Enrollment ID: I20131106000479 |
| Provider Name | Kelly L Thomas |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1740596139 PECOS PAC ID: 1850529991 Enrollment ID: I20140116001129 |
| Provider Name | Kimberly L Podmore |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1245643899 PECOS PAC ID: 8022235019 Enrollment ID: I20140815000054 |
| Provider Name | Lara Hewson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1477896777 PECOS PAC ID: 9537463708 Enrollment ID: I20160209000414 |
| Provider Name | Jennifer C Thompson |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1609994276 PECOS PAC ID: 1456632348 Enrollment ID: I20170109001723 |
| Provider Name | Jose Carrera |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1275983280 PECOS PAC ID: 2668730425 Enrollment ID: I20171227002492 |
| Provider Name | Carol L Dixon |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1144286600 PECOS PAC ID: 8022261767 Enrollment ID: I20180202001652 |
| Provider Name | Craig S Mefford |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1427137900 PECOS PAC ID: 2860743101 Enrollment ID: I20180925002940 |
| Provider Name | Katharine N Thakkar |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1710423553 PECOS PAC ID: 9436567260 Enrollment ID: I20210416000296 |
| Provider Name | Kelly Fitzpatrick |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1417517087 PECOS PAC ID: 6002219250 Enrollment ID: I20210726001424 |
| Provider Name | Valerie R Bradley-holliday |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1548450877 PECOS PAC ID: 6204231251 Enrollment ID: I20210830000752 |
| Provider Name | Sigrid Julian Dixon |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1639573132 PECOS PAC ID: 2567867534 Enrollment ID: I20210830001497 |
| Provider Name | Rachel Korest |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1689249740 PECOS PAC ID: 6406229418 Enrollment ID: I20230222000913 |
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