MEDICARE: PSYCHOLOGICAL SERVICES

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103T00000X	Psychologist	LE002799	MI
2	104100000X	Social Worker	KL064381	MI
3	103T00000X	Psychologist	CH007419	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	CH007419	OTHER	MI	CAROL HATCHER'S LIC#
2	LE012182	OTHER	MI	LYNNE EMERSON LIC#
3	KL064381	OTHER	MI	KATHY LARKEY-GREEN'S LIC#

General Provider Information

NPI Number	:	1295959005
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PSYCHOLOGICAL SERVICES

Provider Business Mailing Address
First Line	:	3448 E LAKE LANSING RD
Second Line	:
City	:	EAST LANSING
State	:	MI
Zip	:	48823-1511
Country	:	US
Telephone Number	:	517-332-3870
Fax Number	:	517-332-9247

Provider Business Practice Location Address
First Line	:	3448 E LAKE LANSING RD
Second Line	:
City	:	EAST LANSING
State	:	MI
Zip	:	48823-1511
Country	:	US
Telephone Number	:	517-332-3870
Fax Number	:	517-332-9247

Authorized Official
Title or Position	:	OWNER
Name	:	CAROL L HATCHER
Credential	:	PH.D
Telephone Number	:	517-332-3870

Provider Enumeration Date	:	04/12/2007
Last Update Date	:	09/11/2025

Similar Medicare Providers

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Practice Location Address:

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1851468839 — DR. NANCY BERNTHAL PHD
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Practice Location Address:

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1356010144 — RESIDENTIAL & COMMUNITY BASED SERVICES, INC.
Practice Location Address:

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Directions to “PSYCHOLOGICAL SERVICES ” Practice Location

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