Active NPI
John Devine
- Marriage & Family Therapist
- Southgate, MI
National Provider Identifier
1093253304
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 4101007013
- Practice address
- 1 Heritage Dr Ste 520
Southgate, MI 48195-3051 - Phone
- (734) 215-9800
- NPI assigned
- Feb 7, 2017
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 4101007013 | MI | Primary |
Addresses
Primary practice location
1 Heritage Dr Ste 520
Southgate, MI 48195-3051
Mailing address
1 Heritage Dr Ste 520
Southgate, MI 48195-3051
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4101007013 | MI | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1486425600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1605139200000",
"number": "1093253304",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 HERITAGE DR STE 520",
"city": "SOUTHGATE",
"state": "MI",
"postal_code": "481953051"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 HERITAGE DR STE 520",
"city": "SOUTHGATE",
"state": "MI",
"postal_code": "481953051",
"telephone_number": "734-215-9800"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEVINE",
"first_name": "JOHN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-02-07",
"last_updated": "2020-11-12",
"certification_date": "2020-11-12",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "MI",
"license": "4101007013",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Southgate, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.