| Mclaren Greater Lansing | |
|
401 W Greenlawn Ave Ste 110 Ingham Regional Medical Center Lansing MI 48910 | |
| (517) 334-2121 | |
| Not Available |
| Full Name | Mclaren Greater Lansing |
|---|---|
| Speciality | Psychologist |
| Location | 401 W Greenlawn Ave Ste 110, Lansing, Michigan |
| Authorized Official Name and Position | Dale Thompson (CFO) |
| Authorized Official Contact | 5179757555 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mclaren Greater Lansing 2111 Univeristy Park Dr Ste 800 Okemos MI 48864 Ph: (517) 908-0039 | Mclaren Greater Lansing 401 W Greenlawn Ave Ste 110 Ingham Regional Medical Center Lansing MI 48910 Ph: (517) 334-2121 |
| NPI Number | 1558556332 |
|---|---|
| Provider Enumeration Date | 09/13/2007 |
| Last Update Date | 08/02/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558556332 | NPI | - | NPPES |
| 3375736 | Medicaid | MI | |
| 4327359 | Medicaid | MI | |
| 4402874 | Medicaid | MI | |
| 4363604 | Medicaid | MI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | 064510 (Michigan) | Primary |
| 208000000X | Pediatrics | (* (Not Available)) | Secondary |
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