Active NPI
Brooke Ingersoll, PHD
- Psychologist
- East Lansing, MI
National Provider Identifier
1114436623
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 6301013668
- Practice address
- 316 Physics Rd
East Lansing, MI 48824-5604 - Phone
- (517) 432-8412
- NPI assigned
- Sep 27, 2017
- 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 | 6301013668 | MI | Primary |
Addresses
Primary practice location
316 Physics Rd
East Lansing, MI 48824-5604
Mailing address
316 Physics Rd
East Lansing, MI 48824-5604
Phone (517) 432-8412
Other practice location 1
935 Rosewood Ave
East Lansing, MI 48823-3126
Phone (517) 930-2275
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
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6301013668 | MI | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1506470400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1114436623",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "316 PHYSICS RD",
"city": "EAST LANSING",
"state": "MI",
"postal_code": "488245604",
"telephone_number": "517-432-8412"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "316 PHYSICS RD",
"city": "EAST LANSING",
"state": "MI",
"postal_code": "488245604",
"telephone_number": "517-432-8412"
}
],
"practiceLocations": [
{
"address_1": "935 Rosewood Ave",
"address_purpose": "LOCATION",
"city": "East Lansing",
"state": "MI",
"postal_code": "488233126",
"country_code": "US",
"telephone_number": "517-930-2275",
"fax_number": "517-930-2275",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "INGERSOLL",
"first_name": "BROOKE",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-09-27",
"last_updated": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "MI",
"license": "6301013668",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in East Lansing, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.