GENESIS PSYCHOLOGICAL SERVICES, P.C. (NPI# 1073684114) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073684114 |
| Entity Type | Organization |
| Organization Name | GENESIS PSYCHOLOGICAL SERVICES, P.C. |
| Practice Address |
415 S Lafayette St South Lyon MI 48178-1458 |
| Practice Telephone | 2484460200 |
| Practice Fax Number | 2484460355 |
| Mailing Telephone | 2484460200 |
| Mailing Fax Number | 2484460355 |
| Enumeration Date | 2006-11-12 |
| Last Update Date | 2008-10-31 |
| Authorized Official Name | DR. JAMES L. DAY (PRESIDENT) |
| Authorized Official Telephone | 2484460200 |
| Authorized Official Credential | PH.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
6301003335 | MI | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | BLUE CROSS BLUE SHIELD | 680F332290 | 01 |
| Street Address |
415 S LAFAYETTE ST |
| City | SOUTH LYON |
| State | MI |
| Zip Code | 48178-1458 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104901081 | James Lawrence Day | Psychologist | 415 S Lafayette St, South Lyon, MI 48178-1458 | 2006-10-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083231815 | Bhoomi Shah | Pharmacist | 22318 Pontiac Trail, South Lyon, MI 48178 | 2020-06-27 |
| 1649811845 | Center for Emdr and Trauma Therapy | Counselor | 28900 Pontiac Trail, South Lyon, MI 48178 | 2019-09-30 |
| 1295223386 | Cathrine Michelle Arneson | Massage Therapist | 321 Pettibone St. #101a, South Lyon, MI 48178 | 2018-04-25 |
| 1033592936 | 4-serv Family Medicine P.C. | Family Medicine | 51619 Ten Mile Rd, South Lyon, MI 48178 | 2015-07-09 |
| 1003299777 | James Sullivan | Physical Therapy Assistant | 10821 Bouldercrest Drive, South Lyon, MI 48178 | 2015-06-30 |
| 1255722088 | Jennifer Nidetz | Social Worker | 23015 Cheyenne Dr, South Lyon, MI 48178 | 2015-02-16 |
| 1174938658 | Michael Samir Matar | Family Medicine | 210 N Lafayette Street, South Lyon, MI 48178 | 2014-06-24 |
| 1043633191 | Kwonsoo Kenneth Kim | Anesthesiology | 8854 Stoney Creek Dr., South Lyon, MI 48178 | 2014-01-27 |
| 1285071860 | Ajanthan Sivagurunathan | Student in an Organized Health Care Education/Training Program | 210 North Lafayette, Providence Medical Center - South Lyon, South Lyon, MI 48178 | 2013-05-23 |
| 1184890055 | Yvonne Marie Snyder | Dentist | 100 E Lake St, South Lyon, MI 48178 | 2008-05-01 |
| Find all providers in zip 48178 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104901081 | James Lawrence Day | Psychologist | 415 S Lafayette St, South Lyon, MI 48178-1458 | 2006-10-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245831296 | Reema S. Beri, Phd, LLC | Psychologist | 49410 Waterstone Estates Cir, Northville, MI 48168-4900 | 2020-11-05 |
| 1952901225 | Northerner Psychological Services, Pllc | Psychologist | 1869 Melbourne St, Birmingham, MI 48009-1160 | 2020-10-27 |
| 1083213631 | Robert J. Sheppard Phd Pllc | Psychologist | 8339 Brookwood Dr, Portage, MI 49024-5207 | 2020-10-23 |
| 1952900037 | Jamila Simone Steward | Psychologist | 31275 Northwestern Hwy Ste 216, Farmington Hills, MI 48334-2570 | 2020-10-20 |
| 1992303465 | Madison Bryant | Psychologist | 1231 S Cass Lake Rd, Waterford, MI 48328-4739 | 2020-10-15 |
| 1730787664 | Athal Yako | Psychologist | 18230 Teresa Dr, Macomb, MI 48044-1681 | 2020-10-13 |
| 1538767678 | Up Telehealth, LLC | Psychologist | 228 W Washington St Ste 7, Marquette, MI 49855-4330 | 2020-10-12 |
| 1881292076 | Meaningful Change: Clinical & Consultation Psychology, Pllc | Psychologist | 1861 Woodland Dr, Mount Pleasant, MI 48858-1298 | 2020-10-11 |
| 1902404122 | Dorrean Riley | Psychologist | 19189 Lexington, Redford, MI 48240-2618 | 2020-10-09 |
| 1174130850 | Timber Creek Counseling West LLC | Psychologist | 2976 Ivanrest Ave Sw Ste 215, Grandville, MI 49418-1440 | 2020-09-28 |
| Find all providers with the same taxonomy | ||||
| City | SOUTH LYON |
| Zip Code | 48178 |
Please comment or provide details below to improve the information on GENESIS PSYCHOLOGICAL SERVICES, P.C..
| 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.