Organization
PSYCHOLOGICAL AND CONSULTATION SERVICES PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PRISCILLA WADE PH.D. (LICENSED PSYCHOLOGIST, PRESIDENT)
(517) 336-7366
Entity
Organization
Contact information
Practice address
4123 OKEMOS RD STE 15, OKEMOS, MI 48864-2818
(517) 336-7366
(517) 336-0808
Mailing address
PO BOX 4455, EAST LANSING, MI 48826-4455
(517) 336-7366
(517) 336-0808
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11291411
B;UE CROSS TRUST
MI
01
—
1871650291
BANKER'S FIDELITY LIFE INSURANCE
MI
01
—
200000006054
PHYSICIAN HEALTH PLAN
MI
01
—
68OC346780
BCBSM
MI
01
—
900080140
PRIORITY HEALTH
MI
01
—
A185414
BEACON HEALTH OPTIONS INC
MI
01
—
R1016708
MCLAREN
MI
Enumeration date
12/20/2006
Last updated
07/06/2020
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