Active NPI
Alan Jacob Thain
- Counseling Psychologist
- Troy, MI
National Provider Identifier
1124573258
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counseling Psychologist
- License
- 6301016758
- Practice address
- 1777 Axtell Dr
#100
Troy, MI 48084-4404 - Phone
- (248) 613-5377
- NPI assigned
- Aug 18, 2016
- 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 |
|---|---|---|---|---|
| Counseling Psychologist | 103TC1900X | 6301016758 | MI | Primary |
Addresses
Primary practice location
1777 Axtell Dr
#100
Troy, MI 48084-4404
Mailing address
508 E Hudson Ave
Royal Oak, MI 48067-3350
Phone (414) 336-8997
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 |
|---|---|---|---|
| 6301016758 | MI | MD | Counseling Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1471478400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1471478400000",
"number": "1124573258",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "508 E HUDSON AVE",
"city": "ROYAL OAK",
"state": "MI",
"postal_code": "480673350",
"telephone_number": "414-336-8997"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1777 AXTELL DR",
"address_2": "#100",
"city": "TROY",
"state": "MI",
"postal_code": "480844404",
"telephone_number": "248-613-5377"
}
],
"practiceLocations": [],
"basic": {
"last_name": "THAIN",
"first_name": "ALAN",
"middle_name": "JACOB",
"name_prefix": "Mr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-08-18",
"last_updated": "2016-08-18",
"status": "A"
},
"taxonomies": [
{
"code": "103TC1900X",
"taxonomy_group": "",
"desc": "Psychologist, Counseling",
"state": "MI",
"license": "6301016758",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Troy, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.