Individual provider Active NPI

Christina Haemmerle, PH.D.

  • Psychologist
  • Rochester Hills, MI
National Provider Identifier
1134314529
Registry record updated Sep 10, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
630101010779 Issued in MI
Practice address
2565 S Rochester Rd
Suite 108B
Rochester Hills, MI 48307-4472
Phone
(248) 852-7907
Fax
(248) 852-7791
NPI assigned
Sep 10, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 10, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 630101010779 MI Primary

Addresses

Primary practice location

2565 S Rochester Rd
Suite 108B
Rochester Hills, MI 48307-4472

Mailing address

2565 S Rochester Rd
Suite 108B
Rochester Hills, MI 48307-4472
Phone (248) 852-7907

Other identifiers 1

IdentifierTypeStateIssuer
0F33286OtherMIUPIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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

Enrollment IDStateProvider typePAC IDDetails
I20071105000146 MI Practitioner - Clinical Psychologist 6406943653 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1999
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

705 Barclay Cir
Suite 110
Rochester Hills, MI 48307-4575
Phone 24885279071

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
630101010779MIMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Myrtle C. Means, PH.D., P.C. PastSince Jul 1, 2003 Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1189382400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1189382400000",
    "number": "1134314529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2565 S ROCHESTER RD",
            "address_2": "SUITE 108B",
            "city": "ROCHESTER HILLS",
            "state": "MI",
            "postal_code": "483074472",
            "telephone_number": "248-852-7907",
            "fax_number": "248-852-7791"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2565 S ROCHESTER RD",
            "address_2": "SUITE 108B",
            "city": "ROCHESTER HILLS",
            "state": "MI",
            "postal_code": "483074472",
            "telephone_number": "248-852-7907",
            "fax_number": "248-852-7791"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAEMMERLE",
        "first_name": "CHRISTINA",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-09-10",
        "last_updated": "2007-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MI",
            "license": "630101010779",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UPIN",
            "identifier": "0F33286",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester Hills, MI

Sources for this page

Verify at the official NPI Registry.