PETER M LISIECKI PHD PC INC (NPI# 1043352701) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1043352701 |
| Entity Type | Organization |
| Organization Name | PETER M LISIECKI PHD PC INC |
| Practice Address |
7960 W. Grand River Ste 120 Brighton MI 48114-7335 |
| Mailing Address |
7960 Grand River Rd Ste 120 Brighton MI 48114-7335 |
| Practice Telephone | 8102271999 |
| Practice Fax Number | 8102252265 |
| Enumeration Date | 2007-02-12 |
| Last Update Date | 2010-06-17 |
| Authorized Official Name | DR. PETER MICHAEL LISIECKI (PRESIDENT) |
| Authorized Official Telephone | 8102271999 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103T00000X | Psychologist | 6301003173 | MI | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | BCBSM PIN | 680D745030 | 01 |
| MI | VALUE OPTIONS PIN | 045199 | 01 |
| Street Address |
7960 W. GRAND RIVER STE 120 |
| City | BRIGHTON |
| State | MI |
| Zip Code | 48114-7335 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457741373 | John B. Rasor D.o, P.C. | Preferred Provider Organization | 7960 W. Grand River, Suite 160, Brighton, MI 48843 | 2015-01-30 |
| 1427472075 | Kristen Marie Culbert | Psychologist | 7960 W. Grand River, Suite 120, Brighton, MI 48114-7335 | 2014-02-18 |
| 1174642672 | Saint Joseph Mercy Livingston Hospital | Psychiatry & Neurology | 7960 W. Grand River, Suite 110, Brighton, MI 48116-6541 | 2007-03-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386114866 | Key Development Center, Inc. | Counselor | 2060 Grand River Annex Suite 600, Brighton, MI 48114 | 2018-11-28 |
| 1205326873 | Montana Neurology Pllc | Psychiatry & Neurology | 2040 Grand River Anx Ste 200, Brighton, MI 48114 | 2018-05-18 |
| 1205370855 | Samantha Hawley | Contractor | 73 Perch Street, Brighton, MI 48114 | 2016-12-15 |
| 1164883633 | Kathryn Degrande Lankton | Family Medicine | 7575 Grand River Ste 210, Brighton, MI 48114 | 2016-03-11 |
| 1992110241 | Bryant Castelein | Podiatrist | 7990 Grand River Rd Ste D, Brighton, MI 48114 | 2014-06-25 |
| 1033544945 | Maria Kottke | Nurse Practitioner | 3222 Eden Trl, Brighton, MI 48114 | 2013-09-10 |
| 1720380462 | Kami Erin Bartholomew | Physical Therapy Assistant | 744 Grand River, Brighton, MI 48114 | 2010-12-01 |
| 1467779223 | Amy Hund | Psychologist | 10031 Spencer Rd, Brighton, MI 48114 | 2010-05-03 |
| 1851529978 | Mark Brian Mcintee | Physician Assistant | 7575 W. Grand River, Brighton, MI 48114 | 2009-06-26 |
| 1982865432 | Disha Kinra | Dentist | 7743 Grand River Ave Ste 202, Great Expressions Dental Centers, Brighton, MI 48114 | 2008-06-18 |
| Find all providers in zip 48114 | ||||
| Taxonomy Code | 103T00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public. |
| Notes: Source: American Psychological Association [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184246241 | Maureen Kenny | Psychologist | 36 Cummings Rd Apt 3, Brighton, MA 02135-7344 | 2020-05-12 |
| 1386133049 | Ralph James Buonopane | Psychologist | 30 Warren St Unit 1, Brighton, MA 02135-3680 | 2018-05-08 |
| 1467779223 | Amy Hund | Psychologist | 10031 Spencer Rd, Brighton, MI 48114 | 2010-05-03 |
| 1013145879 | Mindful Living Pllc | Psychologist | 810 E Grand River Ave Ste 101, Brighton, MI 48116-1878 | 2009-06-30 |
| 1215176151 | Donnah Canavan | Psychologist | 16 Malbert Rd, Brighton, MA 02135-2619 | 2009-02-17 |
| 1548419617 | Doreen Csokasy | Psychologist | 10315 E. Grand River, Brighton, MI 48116 | 2008-09-15 |
| 1982737441 | Jeff David Froyd | Psychologist | 30 S 3rd Ave, Brighton, CO 80601-2008 | 2007-03-13 |
| 1437218518 | Elaine Marie Tripi | Psychologist | 2000 Grand River Anx, Ste 300, Brighton, MI 48114-3800 | 2006-12-06 |
| 1184647455 | Olga C Bachmann-thompson | Psychologist | 325 E. Grand River, Ste. 7, Brighton, MI 48116 | 2006-07-26 |
| 1841216264 | Jerry Csokasy | Psychologist | 10315 E Grand River, Suite 304, Brighton, MI 48116 | 2006-07-15 |
| Find all providers in BRIGHTON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.