Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mr. Mark Cannizzaro, PHD

Individual provider Psychologist · NPI 1144373812

Mr. Mark Cannizzaro, PHD is a Clinical Psychologist in Lansing, Michigan. Qualified in 2002, 24 years ago. Practices as a sole proprietor, accepts Medicare assignment and offers telehealth. Licensed in Michigan.

Years since qualifying
24
Licensed in
MI
In the registry since
2007
What do these letters mean?
PHD — Doctor of Philosophy
A research doctorate. In healthcare it usually sits alongside a clinical licence.

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Practice location Address checks out

120 N Washington Sq Ste 300
Lansing, MI 48933-1658
Phone: (734) 210-1854
Fax: (517) 627-1289
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Psychologist (primary) Taxonomy 103T00000X · Licence 6301012725 (MI)

Record details

NPI number1144373812
Entity typeIndividual (Type 1)
GenderMale
Credentials PHD
Sole proprietorYes
NPI enumeratedJanuary 18, 2007
Last updated in NPPESMarch 13, 2020
Certification dateMarch 13, 2020
Mailing address120 N Washington Sq Ste 300, Lansing, MI 48933-1658

Medicare enrollment

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

Medicare specialtyCLINICAL PSYCHOLOGIST
Medical schoolOTHER
Graduated 2002 (24 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

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