Organization Active NPI

Sylvia Gordon, PH.D., PC

  • Clinical Psychologist
  • Ann Arbor, MI
National Provider Identifier
1043513450
Registry record updated Dec 8, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
6301001833 Issued in MI
Legal business name
SYLVIA GORDON, PH.D., PC
Practice address
2127 Brockman Blvd
Ann Arbor, MI 48104-4529
Phone
(734) 994-7147
NPI assigned
Dec 8, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2010

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

Authorized official

Name
Ms. Sylvia Ann Gordon, PH.D.
Title
President/Owner
Phone
(734) 994-7147

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X 6301001833 MI Primary

Addresses

Primary practice location

2127 Brockman Blvd
Ann Arbor, MI 48104-4529

Mailing address

2127 Brockman Blvd
Ann Arbor, MI 48104-4529
Phone (734) 994-7147

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1291766400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1291766400000",
    "number": "1043513450",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2127 BROCKMAN BLVD",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481044529",
            "telephone_number": "734-994-7147"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2127 BROCKMAN BLVD",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481044529",
            "telephone_number": "734-994-7147"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SYLVIA GORDON, PH.D., PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-12-08",
        "last_updated": "2010-12-08",
        "status": "A",
        "authorized_official_last_name": "GORDON",
        "authorized_official_first_name": "SYLVIA",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "734-994-7147",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6301001833",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ann Arbor, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2010; 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.