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Organization
LIST PSYCHOLOGICAL SERVICES
Active
Organization
LIST PSYCHOLOGICAL SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DIANE R LIST PHD (CHIEF EXECUTIVE OFFICER)
(989) 672-6160
Entity
Organization
Contact information
Practice address
1600 N MICHIGAN AVE, ROOM 506, SAGINAW, MI 48602-5306
(989) 758-3720
(989) 758-3760
Mailing address
443 N STATE ST, CARO, MI 48723-1539
(989) 672-6160
(989) 672-5649
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
NULL
101Y00000X
Counselor
—
—
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
MI
101YM0800X
Mental Health Counselor
—
NULL
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
—
NULL
101YP2500X
Professional Counselor
—
—
103TC0700X
Clinical Psychologist
—
NULL
103TC0700X
Clinical Psychologist
—
—
104100000X
Social Worker
—
NULL
104100000X
Social Worker
—
—
1041C0700X
Clinical Social Worker
—
NULL
1041C0700X
Clinical Social Worker
—
—
106H00000X
Marriage & Family Therapist
—
NULL
106H00000X
Marriage & Family Therapist
—
—
Other
Enumeration date
12/16/2009
Last updated
12/16/2009
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