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Organization
LIST PSYCHOLOGICAL SERVICES, PLC
Active
Organization
LIST PSYCHOLOGICAL SERVICES, PLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JACQUELINE THOMPSON (COO)
(989) 672-6160
Entity
Organization
Contact information
Practice address
624 W NEPESSING ST, SUITE 300, LAPEER, MI 48446-2090
(810) 667-4500
(810) 667-4500
Mailing address
443 N STATE ST, CARO, MI 48723-1539
(989) 672-6160
(989) 672-5649
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
034530
VALUE OPTIONS
MI
01
—
0D41044
BCBS PSYCHIATRIST
MI
01
—
1006309
MCLAREN HEALTH ADVANTAGE
MI
01
—
750910965
BCBS OF MICHIGAN
MI
Enumeration date
05/12/2006
Last updated
12/27/2016
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