Lister, Michael Bruce

Lister, Michael Bruce is an sole proprietor health care provider with primary practice located at 423 E Main St #2, Endicott NY 13760-6940. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical, Behavioral Health & Social Service Providers / Adult Development & Aging. Behavioral Health & Social Service Providers / Clinical is his primary health care specialty. Lister, Michael Bruce can be contacted via phone (607) 754-1101.

Contact Information

Primary practice address
423 E Main St #2 Endicott NY 13760-6940
Phone: (607) 754-1101
Fax: (607) 754-1107
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X 0810004531 Virginia
Behavioral Health & Social Service Providers / Adult Development & Aging 103TA0700X 0810004531 Virginia
Behavioral Health & Social Service Providers / Clinical 103TC0700X 021193-1 New York

Profile Details

NPI number 1215203914
LBN Legal business name Lister, Michael Bruce
Credentials PSY.D.
Entity Individual
Sole proprietor 1 Yes
Enumeration date Mar 27th, 2012
Last updated Aug 12th, 2015 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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