| Organization Name: | GENESIS PSYCHOLOGICAL SERVICES, P.C. |
| NPI Number: | 1073684114 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JAMES L. DAY (PRESIDENT) |
| Mailing Address: | 415 S Lafayette St South Lyon |
| State: | MI US |
| Postal Code: | 481781458 |
| Phone Number: | 2484460200 |
| Fax Number: | 2484460355 |
| NPI Enumeration Date: | 11/12/2006 |
| NPI Last Update Date: | 10/31/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC0700X |
| License Number: | 6301003335 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MI |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | |