Active NPI
Derek Thomas Rosen, MA/LLP
- Psychologist
- Redford, MI
National Provider Identifier
1033433602
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 6301014393
- Practice address
- 9315 Telegraph Rd
Redford, MI 48239-1260 - Phone
- (180) 045-0450
- NPI assigned
- Mar 25, 2010
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 6301014393 | MI | Primary |
Addresses
Primary practice location
9315 Telegraph Rd
Redford, MI 48239-1260
Mailing address
18781 Hannan Rd
New Boston, MI 48164-9368
Phone (734) 642-5523
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6301014393 | MI | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1269475200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1483574400000",
"number": "1033433602",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "18781 HANNAN RD",
"city": "NEW BOSTON",
"state": "MI",
"postal_code": "481649368",
"telephone_number": "734-642-5523"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9315 TELEGRAPH RD",
"city": "REDFORD",
"state": "MI",
"postal_code": "482391260",
"telephone_number": "180-045-0450"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROSEN",
"first_name": "DEREK",
"middle_name": "THOMAS",
"name_prefix": "Mr.",
"credential": "MA/LLP",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2010-03-25",
"last_updated": "2017-01-05",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "MI",
"license": "6301014393",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Redford, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.