Individual provider Active NPI

Jeffry Bruce Hillenberg, PH.D.

  • Clinical Psychologist
  • Royal Oak, MI
National Provider Identifier
1033158324
Registry record updated May 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
6301006433 Issued in MI
Practice address
3577 W 13 Mile Rd
Suite 142
Royal Oak, MI 48073-6710
Phone
(248) 892-4364
Fax
(248) 551-8437
NPI assigned
Jun 5, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 14, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 6301006433 MI Primary

Addresses

Primary practice location

3577 W 13 Mile Rd
Suite 142
Royal Oak, MI 48073-6710

Mailing address

6725 Daly Rd #250951
West Bloomfield, MI 48322-3421
Phone (248) 892-4364

Other practice location 1

6725 Daly Rd # 250951
West Bloomfield, MI 48322-3421
Phone (248) 892-4364

Other identifiers 1

IdentifierTypeStateIssuer
71020000F34840OtherMIBLUE CROSS AND BLUE SHIEL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080325000387 MI Practitioner - Clinical Psychologist 3971584905 Reassigns benefits to 1 organization
Practice locations: Bloomfield Hills, MI

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

74 W Long Lake Rd
Suite 201
Bloomfield Hills, MI 48304-2775
Phone (248) 642-6066

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

Practice roles

OrganizationSpecialtyStatusNew patients
Mental Health Specialty Group PA CurrentSince May 12, 2025 Accepting new patients
Affiliated Psychologists of Michigan, P.C. PastSince Apr 21, 2011 Accepting new patients

Locations

400 Renaissance Ctr
Detroit, MI 48243
Phone (248) 599-1582

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1149465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778716800000",
    "number": "1033158324",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6725 DALY RD #250951",
            "city": "WEST BLOOMFIELD",
            "state": "MI",
            "postal_code": "483223421",
            "telephone_number": "248-892-4364",
            "fax_number": "248-855-3983"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3577 W 13 MILE RD",
            "address_2": "SUITE 142",
            "city": "ROYAL OAK",
            "state": "MI",
            "postal_code": "480736710",
            "telephone_number": "248-892-4364",
            "fax_number": "248-551-8437"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6725 Daly Rd # 250951",
            "address_purpose": "LOCATION",
            "city": "West Bloomfield",
            "state": "MI",
            "postal_code": "483223421",
            "country_code": "US",
            "telephone_number": "248-892-4364",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HILLENBERG",
        "first_name": "JEFFRY",
        "middle_name": "BRUCE",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-05",
        "last_updated": "2026-05-14",
        "certification_date": "2026-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6301006433",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS AND BLUE SHIEL",
            "identifier": "71020000F34840",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Royal Oak, MI

Sources for this page

Verify at the official NPI Registry.