NPIMap

Organization Active NPI

Wayne State University Psychology Clinic

  • Community/Behavioral Health Agency
  • Detroit, MI
National Provider Identifier
1104095868
Registry record updated Feb 27, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
WAYNE STATE UNIVERSITY PSYCHOLOGY CLINIC
Practice address
60 Farnsworth St, Rackham BLDG
RM. 109
Detroit, MI 48202-4060
Phone
(313) 577-2840
Fax
(313) 577-8949
NPI assigned
Feb 27, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2008

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

Authorized official

Name
Dr. Douglas Barnett, PH.D.
Title
Director
Phone
(313) 577-2840

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

60 Farnsworth St, Rackham BLDG
RM. 109
Detroit, MI 48202-4060

Mailing address

60 Farnsworth St, Rackham BLDG
RM. 109
Detroit, MI 48202
Phone (313) 577-2840

National Provider Directory

National Provider Directory
Tax ID family
Detroit Receiving Hospital3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

60 Farnsworth St
Rm 109
Detroit, MI 48202
Phone (313) 577-2840

NPI Registry JSON

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

{
    "created_epoch": "1204070400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1204070400000",
    "number": "1104095868",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "60 FARNSWORTH ST, RACKHAM BLDG",
            "address_2": "RM. 109",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "48202",
            "telephone_number": "313-577-2840",
            "fax_number": "313-577-8949"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "60 FARNSWORTH ST, RACKHAM BLDG",
            "address_2": "RM. 109",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482024060",
            "telephone_number": "313-577-2840",
            "fax_number": "313-577-8949"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WAYNE STATE UNIVERSITY PSYCHOLOGY CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-27",
        "last_updated": "2008-02-27",
        "status": "A",
        "authorized_official_last_name": "BARNETT",
        "authorized_official_first_name": "DOUGLAS",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "313-577-2840",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2008; 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.