Michael Summerlin, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY28000 Issued in CA

Practice address

1940 W Orangewood Ave
Ste. 105
Orange, CA 92868-2009

Phone

(714) 494-1867

NPI assigned

Mar 8, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

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

Specialty

Clinical Psychologist

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

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.

• Michael Wesley Summerlin PHD Ek Psych

  • Clinical Psychologist
  • Newport Beach, CA
  • NPI 1932450889
  Medicare reassignment NPD Authorized official
• Ek Psych - Emotive Knowledge Psychology a Professional Corporation

  • Clinical Psychologist
  • Newport Beach, CA
  • NPI 1548983836
  NPD Authorized official

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

{
    "created_epoch": "1173312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1465257600000",
    "number": "1083745152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1940 W ORANGEWOOD AVE",
            "address_2": "STE. 105",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928682009",
            "telephone_number": "714-494-1867"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1940 W ORANGEWOOD AVE",
            "address_2": "STE. 105",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928682009",
            "telephone_number": "714-494-1867"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUMMERLIN",
        "first_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-08",
        "last_updated": "2016-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "43233",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY28000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shannon Allison Sullivan
• Dilara Sultana, PSYCHIATRY NURSE PRA
• Rylee Anne Sulzer
• Sharlyn Ann Sumbillo Park, MS CCC-SLP
• Leanne Brigh Sumbong
• Summerville at Cobbco, Inc.
• Bryan Sun, M.D., PH.D
• Carol Lucia Sun
• Coral Sun, M.D.
• Georgia Markou Sun, M.D.

• Clinical Psychologist in Orange, CA
• Providers in Orange, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.