| Genesis Psychological Services, P.c. | |
|
415 S Lafayette St South Lyon MI 48178-1458 | |
| (248) 446-0200 | |
| (248) 446-0355 |
| Full Name | Genesis Psychological Services, P.c. |
|---|---|
| Speciality | Psychologist - Clinical |
| Location | 415 S Lafayette St, South Lyon, Michigan |
| Authorized Official Name and Position | James L. Day (PRESIDENT) |
| Authorized Official Contact | 2484460200 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Genesis Psychological Services, P.c. 415 S Lafayette St South Lyon MI 48178-1458 Ph: (248) 446-0200 | Genesis Psychological Services, P.c. 415 S Lafayette St South Lyon MI 48178-1458 Ph: (248) 446-0200 |
| NPI Number | 1073684114 |
|---|---|
| Provider Enumeration Date | 11/12/2006 |
| Last Update Date | 10/31/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073684114 | NPI | - | NPPES |
| 680F332290 | Other | MI | BLUE CROSS BLUE SHIELD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 6301003335 (Michigan) | Primary |
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