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

Individual provider Psychologist · NPI 1114455706

Patchawan Phunwutikorn, PSYD is a Clinical Psychologist in Grand Blanc, Michigan. Qualified in 2020, 6 years ago. Practices with Henry Ford Health Genesys Hospital, a 86-clinician group, works from 2 locations, accepts Medicare assignment and offers telehealth.

Years since qualifying
6
In the registry since
2017
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

1 Genesys Pkwy
Grand Blanc, MI 48439-8065
Phone: (810) 606-5126
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 2325 Clement Ave Ste A, Alameda, CA 94501-7061 — (510) 629-6367

Specialties & licences

Psychologist (primary) Taxonomy 103T00000X

Record details

NPI number1114455706
Entity typeIndividual (Type 1)
GenderFemale
Credentials PSYD
Sole proprietorYes
NPI enumeratedMay 26, 2017
Last updated in NPPESAugust 17, 2022
Certification dateAugust 17, 2022
Mailing address2004 Fox Hill Dr Apt 1, Grand Blanc, MI 48439-5244

Medicare enrollment

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

Medicare specialtyCLINICAL PSYCHOLOGIST
Medical schoolOTHER
Graduated 2020 (6 years in practice)
Group practice Henry Ford Health Genesys Hospital — 86 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations2 on file with Medicare

Other providers in Grand Blanc