Healthcare Provider Details

I. General information

NPI: 1073433868
Provider Name (Legal Business Name): LANCASTER& COOK PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/20/2026
Last Update Date: 07/20/2026
Certification Date: 07/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4870 W CLARK RD STE 2
YPSILANTI MI
48197-1104
US

IV. Provider business mailing address

4870 W CLARK RD STE 2
YPSILANTI MI
48197-1104
US

V. Phone/Fax

Practice location:
  • Phone: 402-541-3784
  • Fax:
Mailing address:
  • Phone: 402-541-3784
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TH0100X
TaxonomyHealth Service Psychologist
License Number
License Number State

VIII. Authorized Official

Name: BLAKE LANCASTER
Title or Position: OWNER
Credential: PHD
Phone: 402-541-3784