Healthcare Provider Details

I. General information

NPI: 1467854901
Provider Name (Legal Business Name): OASIS PSYCHOLOGICAL SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/16/2014
Last Update Date: 09/16/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3815 W SAINT JOSEPH ST SUITE A300
LANSING MI
48917-3666
US

IV. Provider business mailing address

3815 W SAINT JOSEPH ST SUITE A300
LANSING MI
48917-3666
US

V. Phone/Fax

Practice location:
  • Phone: 517-489-1468
  • Fax:
Mailing address:
  • Phone: 517-489-1468
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number6801091423
License Number StateMI

VIII. Authorized Official

Name: JENNIFER ROBIN BELL
Title or Position: PSYCHOTHERAPIST
Credential: LMSW
Phone: 517-489-1468