Active NPI
Pamela Vaccarelli
- Psychologist
- Rochester, MI
National Provider Identifier
1073672200
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 6301009087
- Practice address
- 4986 N Adams Rd
Rochester, MI 48306-1416 - Phone
- (248) 475-4880
- NPI assigned
- Dec 6, 2006
- Sex
- Female
- Sole proprietor
- No
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 | 6301009087 | MI | Primary |
Addresses
Primary practice location
4986 N Adams Rd
Rochester, MI 48306-1416
Mailing address
325 Timber TRL Apt 308
Auburn Hills, MI 48326-1197
Phone (313) 920-1165
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6301009087 | MI | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165363200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1073672200",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "325 TIMBER TRL APT 308",
"city": "AUBURN HILLS",
"state": "MI",
"postal_code": "483261197",
"telephone_number": "313-920-1165"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4986 N ADAMS RD",
"city": "ROCHESTER",
"state": "MI",
"postal_code": "483061416",
"telephone_number": "248-475-4880"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VACCARELLI",
"first_name": "PAMELA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-12-06",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "MI",
"license": "6301009087",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rochester, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.