Fred Joseph Durham

Primary specialty

Cognitive & Behavioral PsychologistTaxonomy code 103TB0200X

License

6851118945 Issued in MI

Practice address

26650 Eureka Rd Ste a
Taylor, MI 48180-4835

Phone

(313) 561-5100

NPI assigned

Nov 20, 2024

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1732060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732060800000",
    "number": "1003631433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50216 PAINE ST",
            "city": "CANTON",
            "state": "MI",
            "postal_code": "481883332",
            "telephone_number": "765-431-0547"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26650 EUREKA RD STE A",
            "city": "TAYLOR",
            "state": "MI",
            "postal_code": "481804835",
            "telephone_number": "313-561-5100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DURHAM",
        "first_name": "FRED",
        "middle_name": "JOSEPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-11-20",
        "last_updated": "2024-11-20",
        "certification_date": "2024-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": "MI",
            "license": "6851118945",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Theresa Marie Dubauskas, COTA
• Bharathi Dukkipati, M.D.
• Nicole Dumond, LLP
• Semaj Dunson, LPC
• Thomas Nelson Dupuis, DDS
• Nicole Linette Dykes
• Eai Employment Resources, Inc.
• Eai Employment Resources, Inc.
• Early Solutions Clinic
• East Pointe Psychiatric Services, P.C.

• Cognitive & Behavioral Psychologist in Taylor, MI
• Providers in Taylor, MI by specialty
• Cognitive & Behavioral Psychologist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.