Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Dr. Michael Bruce Lister, PSYD

Individual provider Clinical Psychologist · NPI 1215203914

Dr. Michael Bruce Lister, PSYD is a Clinical Psychologist in Endicott, New York. Qualified in 2010, 16 years ago. Practices as a sole proprietor, accepts Medicare assignment and offers telehealth. Licensed in New York and Virginia.

Years since qualifying
16
Licensed in
NY, VA
In the registry since
2012
Specialties on file
3
What do these letters mean?
PSYD — Doctor of Psychology
A doctoral psychologist trained primarily for clinical practice.

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Practice location Address checks out

423 E Main St #2
Endicott, NY 13760-6940
Phone: (607) 754-1101
Fax: (607) 754-1107
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Psychologist (primary) Taxonomy 103TC0700X · Licence 021193-1 (NY)
Clinical Psychologist Taxonomy 103TC0700X · Licence 0810004531 (VA)
Adult Development & Aging Psychologist Taxonomy 103TA0700X · Licence 0810004531 (VA)

Record details

NPI number1215203914
Entity typeIndividual (Type 1)
GenderMale
Credentials PSYD
Sole proprietorYes
NPI enumeratedMarch 27, 2012
Last updated in NPPESAugust 12, 2015

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL PSYCHOLOGIST
Medical schoolOTHER
Graduated 2010 (16 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

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