| Michigan Psychological, P.c. | |
|
29750 Harper Ave Saint Clair Shores MI 48082-2607 | |
| (586) 777-3200 | |
| (586) 777-7855 |
| Full Name | Michigan Psychological, P.c. |
|---|---|
| Speciality | Psychologist |
| Location | 29750 Harper Ave, Saint Clair Shores, Michigan |
| Authorized Official Name and Position | Paul D Ward (CLINICAL PSYCHOLOGIST/PRESIDENT) |
| Authorized Official Contact | 5867772300 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Michigan Psychological, P.c. 29750 Harper Ave Saint Clair Shores MI 48082-2607 Ph: (586) 777-3200 | Michigan Psychological, P.c. 29750 Harper Ave Saint Clair Shores MI 48082-2607 Ph: (586) 777-3200 |
| NPI Number | 1801102744 |
|---|---|
| Provider Enumeration Date | 08/30/2010 |
| Last Update Date | 02/23/2021 |
| Certification Date | 02/23/2021 |
| Medicare PECOS PAC ID | 3274968672 |
|---|---|
| Medicare Enrollment ID | O20200113001497 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801102744 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 6301014162 (Michigan) | Primary |
| Provider Name | Cynthia A Konal |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1578698452 PECOS PAC ID: 9234117466 Enrollment ID: I20040713000581 |
| Provider Name | Paul D Ward |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1225294200 PECOS PAC ID: 2961533724 Enrollment ID: I20100623000691 |
| Provider Name | Elizabeth M Hanvey |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1679675201 PECOS PAC ID: 6709069230 Enrollment ID: I20110322000231 |
| Provider Name | Julie A Phillips |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1902103542 PECOS PAC ID: 2567616345 Enrollment ID: I20130201000233 |
| Provider Name | Andrea L Pulte |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1154696938 PECOS PAC ID: 8123454550 Enrollment ID: I20200204000573 |
| Provider Name | Jessica Kidd |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1255688354 PECOS PAC ID: 2860821782 Enrollment ID: I20200327003115 |
| Provider Name | Stephanie Mcgarity |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1265820286 PECOS PAC ID: 5597187476 Enrollment ID: I20200623001129 |
| Provider Name | Christopher Lecznar |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1467945956 PECOS PAC ID: 4587005137 Enrollment ID: I20240514000714 |
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