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NPI Code Detail

MEDICARE: MICHELLE LYNN CROCE PSYD, LP

MEDICARE: MICHELLE LYNN CROCE PSYD, LP
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
1103TC0700XClinical Psychologist6301015633MI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
16130461OTHERMIPHP
2P108953080OTHERMIBCBS

General Provider Information

NPI Number : 1598815342
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHELLE LYNN CROCE PSYD, LP
Provider Business Mailing Address
First Line : PO BOX 466
Second Line :
City : MARSHALL
State : MI
Zip : 49068-0466
Country : US
Telephone Number : 517-279-8866
Fax Number : 517-924-1816
Provider Business Practice Location Address
First Line : 694 W CHICAGO RD
Second Line :
City : COLDWATER
State : MI
Zip : 49036-8405
Country : US
Telephone Number : 517-279-8866
Fax Number : 517-924-1816
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/12/2007
Last Update Date : 11/19/2025

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