Provider Demographics
NPI:1699763763
Name:CHRISTIAN JANSEN-YEE PSYD & ASSOCIATES PC
Entity type:Organization
Organization Name:CHRISTIAN JANSEN-YEE PSYD & ASSOCIATES PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT, LICENSED PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:JANSEN-YEE
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:231-737-1213
Mailing Address - Street 1:3370 GLADE ST
Mailing Address - Street 2:
Mailing Address - City:MUSKEGON
Mailing Address - State:MI
Mailing Address - Zip Code:49444-2778
Mailing Address - Country:US
Mailing Address - Phone:231-737-1213
Mailing Address - Fax:231-737-1218
Practice Address - Street 1:3370 GLADE ST
Practice Address - Street 2:
Practice Address - City:MUSKEGON
Practice Address - State:MI
Practice Address - Zip Code:49444-2778
Practice Address - Country:US
Practice Address - Phone:231-737-1213
Practice Address - Fax:231-737-1218
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-12
Last Update Date:2008-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301013149103G00000X
MI6301006166103TC0700X
MI68010770691041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
No103G00000XBehavioral Health & Social Service ProvidersClinical NeuropsychologistGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI244735000OtherMAGELLAN BEHAVIORAL HEALT
MI680F14516OtherBCBS OF MI
MI0F14516OtherVALUE OPTIONS
MI7000010001OtherPRIORITY HEALTH
MIP-86569OtherBLUE CARE NETWORK
MI7000010001OtherPRIORITY HEALTH