MEDICARE: OAKS PSYCHOLOGY PLLC

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	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number	:	1831041664
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OAKS PSYCHOLOGY PLLC

Provider Business Mailing Address
First Line	:	57189 BRECKENRIDGE DR
Second Line	:
City	:	WASHINGTON TWP
State	:	MI
Zip	:	48094-3578
Country	:	US
Telephone Number	:	517-282-5427
Fax Number	:

Provider Business Practice Location Address
First Line	:	57189 BRECKENRIDGE DR
Second Line	:
City	:	WASHINGTON TWP
State	:	MI
Zip	:	48094-3578
Country	:	US
Telephone Number	:	517-282-5427
Fax Number	:

Authorized Official
Title or Position	:	CLINICAL SOCIAL WORKER
Name	:	JULIANNE RANDALL-MESSENGER
Credential	:	LMSW
Telephone Number	:	517-282-5427

Provider Enumeration Date	:	02/12/2026
Last Update Date	:	02/12/2026

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