Healthcare Provider Details

I. General information

NPI: 1376759639
Provider Name (Legal Business Name): COMPREHENSIVE PSYCHOLOGICAL SERVICES PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/15/2007
Last Update Date: 08/02/2023
Certification Date: 08/02/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2720 E LANSING DR
EAST LANSING MI
48823-7754
US

IV. Provider business mailing address

2720 E LANSING DR
EAST LANSING MI
48823-7754
US

V. Phone/Fax

Practice location:
  • Phone: 517-337-2900
  • Fax:
Mailing address:
  • Phone: 517-337-2900
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: JOHN KEITH OSTIEN
Title or Position: DIRECTOR
Credential: PHD
Phone: 517-337-2900