MEDICARE: CHERRY HILL PSYCHOLOGICAL SERVICES, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	261QM0850X	Adult Mental Health Clinic/Center
2	261Q00000X	Clinic/Center
3	103TC0700X	Clinical Psychologist

General Provider Information

NPI Number	:	1730911199
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHERRY HILL PSYCHOLOGICAL SERVICES, LLC

Provider Business Mailing Address
First Line	:	36500 FORD RD STE 205
Second Line	:
City	:	WESTLAND
State	:	MI
Zip	:	48185-3769
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	29532 SOUTHFIELD RD STE 115
Second Line	:
City	:	SOUTHFIELD
State	:	MI
Zip	:	48076-2023
Country	:	US
Telephone Number	:	810-334-9594
Fax Number	:

Authorized Official
Title or Position	:	CLINICAL PSYCHOLOGIST
Name	:	DR. LINDSAY HAMILTON BROCHHAGEN
Credential	:	PHD
Telephone Number	:	810-334-9594

Provider Enumeration Date	:	08/15/2024
Last Update Date	:	03/24/2026

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