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
MRS. CARIN ANN MONTEI (CONTRACT SUPERVISOR)
(989) 672-6160
Entity
Organization
Contact information
Practice address
110 E HURON AVE, BAD AXE, MI 48413-1312
(989) 672-6160
(989) 672-5649
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
—
—
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YP2500X
Professional Counselor
—
—
103TC0700X
Clinical Psychologist
—
—
1041C0700X
Clinical Social Worker
—
—
106H00000X
Marriage & Family Therapist
—
—
2084P0800X
Psychiatry Physician
—
—
2084P0802X
Addiction Psychiatry Physician
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
01/08/2019
Last updated
01/08/2019
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