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Organization
LIST PSYCHOLOGICAL SERVICES, PLC
Active
Organization
LIST PSYCHOLOGICAL SERVICES, PLC
Active
Parent organization
LIST PSYCHOLOGICAL SERVICES, PLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
LIST PSYCHOLOGICAL SERVICES, PLC
Authorized official
JACQUELINE DIANE LIST (CEO)
(989) 672-6160
Entity
Organization
Contact information
Practice address
33 W SANILAC RD, SANDUSKY, MI 48471-1036
(810) 667-4500
Mailing address
443 N STATE ST, CARO, MI 48723-1539
(989) 672-6160
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YP2500X
Professional Counselor
—
—
103TC0700X
Clinical Psychologist
—
—
1041C0700X
Clinical Social Worker
Primary
—
—
106H00000X
Marriage & Family Therapist
—
—
2084P0800X
Psychiatry Physician
—
—
2084P0802X
Addiction Psychiatry Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NA
NA
—
Enumeration date
04/26/2022
Last updated
05/23/2025
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