OLD TOWN PSYCHOLOGICAL SERVICES-GAYLORD (NPI# 1750659249) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750659249 |
| Entity Type | Organization |
| Organization Name | OLD TOWN PSYCHOLOGICAL SERVICES-GAYLORD |
| Practice Address |
128 N Court Ave Gaylord MI 49735-1408 |
| Mailing Address |
512 S Union St Traverse City MI 49684-3247 |
| Practice Telephone | 9894488344 |
| Mailing Telephone | 2319416550 |
| Mailing Fax Number | 2319418981 |
| Enumeration Date | 2011-12-12 |
| Last Update Date | 2011-12-12 |
| Authorized Official Name | DR. MICHAEL P HAYES (CEO) |
| Authorized Official Telephone | 9894488344 |
| Authorized Official Credential | PH.D. |
| Is Organization Subpart | Y |
| Parent Organization Name | OLD TOWN PSYCHOLOGICAL SERVICES |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC2200X |
Psychologist Specialization: Clinical Child & Adolescent |
Behavioral Health & Social Service Providers |
| Street Address |
128 N COURT AVE |
| City | GAYLORD |
| State | MI |
| Zip Code | 49735-1408 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336611904 | Julia Alexandra Saldana | Counselor | 128 N Court Ave, Gaylord, MI 49735-1408 | 2018-12-20 |
| 1821447723 | Pamela Anne Mcmillan | Psychologist | 128 N Court Ave, Gaylord, MI 49735-1408 | 2016-06-10 |
| 1407297641 | Kristy Somerville | Social Worker | 128 N Court Ave, Gaylord, MI 49735-1408 | 2013-07-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306447453 | Jenni Kirt | Social Worker | 407 I-75 Bus N, Gaylord, MI 49735 | 2020-11-05 |
| 1922584986 | Patricia Dovalina | Behavior Technician | 2285 Michaywe Dr, Otsego Lake, MI 49735 | 2018-07-12 |
| 1265944581 | James Hulbert | Social Worker | 407 W Main Street, Gaylord, MI 49735 | 2017-10-26 |
| 1548792625 | Somer Lawes | Behavior Technician | 2443 Castlewood Dr, Gaylord, MI 49735 | 2017-03-29 |
| 1922554161 | Mark David Mcpherson | Counselor | 2136 West M-32, Gaylord, MI 49735 | 2016-08-28 |
| 1689063034 | Liza Brandt | Behavioral Analyst | 6748 Colonial Ct, Gaylord, MI 49735 | 2015-01-22 |
| 1942597224 | Visions for Your Community Care Hhc | Home Health | 2365 N Perch Lake Dr, Gaylord, MI 49735 | 2011-07-07 |
| 1073778304 | Julie Lynn Vandusen | Community Health Worker | 5512 Clubhouse Trail, Gaylord, MI 49735 | 2008-07-25 |
| 1073708798 | Alpine Chiropractic, PC | Chiropractor | 529 S. Wisconsin Ave, Gaylord, MI 49735 | 2007-09-06 |
| 1669675567 | Oral and Maxillofacial Surgery Associates | Dentist | 785 E M32, Gaylord, MI 49735 | 2007-06-07 |
| Find all providers in zip 49735 | ||||
| Taxonomy Code | 103TC2200X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical Child & Adolescent |
| Definition to come... |
| Notes: [1/1/2007: title modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770184251 | Think To Thrive Psychological Services Pllc | Psychologist | 16250 Northland Dr Ste 204b, Southfield, MI 48075-5205 | 2020-11-03 |
| 1407490006 | Oakland Integrated Healthcare Network | Psychologist | 3825 W Walton Blvd, Room B, Waterford, MI 48329-4270 | 2019-11-06 |
| 1487298204 | Oakland Integrated Healthcare Network | Psychologist | 881 Pinecrest Dr Fl 1, Ferndale, MI 48220-2310 | 2019-11-05 |
| 1952945107 | Oakland Integrated Healthcare Network | Psychologist | 2800 Waukegan St Rm 3, Auburn Hills, MI 48326-3261 | 2019-10-31 |
| 1730723982 | Oakland Integrated Healthcare Network | Psychologist | 32000 Shiawassee Rd Rm B, Farmington Hills, MI 48336-3251 | 2019-10-31 |
| 1558913160 | Anna Snyder | Psychologist | 9223 Sandhill Ct, Saline, MI 48176-9440 | 2019-07-13 |
| 1467965418 | Jeffrey William Thompson | Psychologist | 167 Leota Blvd, Waterford, MI 48327-3631 | 2017-11-13 |
| 1578074621 | Joshua Dale Brewer | Psychologist | 206 W Michigan Ave, Oscoda, MI 48750-1413 | 2017-10-17 |
| 1235655614 | Ramzi Hasson | Psychologist | 21600 Novi Rd # 800, Novi, MI 48375-5605 | 2017-08-17 |
| 1588184832 | Allison Vercellone Hayhoe | Psychologist | 31700 W 12 Mile Rd Ste 100&250, Farmington Hills, MI 48334-4424 | 2017-06-27 |
| Find all providers with the same taxonomy | ||||
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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.