Zachery O Hurd, TLLP

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

6362010056 Issued in MI

Practice address

29750 Harper Ave
Saint Clair Shores, MI 48082-2607

Phone

(586) 777-3200

Fax

(586) 777-7855

NPI assigned

Oct 26, 2024

Last updated

Oct 26, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Michigan Psychological, P.C.

  • Clinical Psychologist
  • Saint Clair Shores, MI
  • NPI 1801102744
  NPD

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

{
    "created_epoch": "1729900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729900800000",
    "number": "1144042755",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29750 HARPER AVE",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "480822607",
            "telephone_number": "248-755-3814",
            "fax_number": "586-777-7855"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29750 HARPER AVE",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "480822607",
            "telephone_number": "586-777-3200",
            "fax_number": "586-777-7855"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HURD",
        "first_name": "ZACHERY",
        "middle_name": "O",
        "name_prefix": "Mr.",
        "credential": "TLLP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-10-26",
        "last_updated": "2024-10-26",
        "certification_date": "2024-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6362010056",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Psychologist in Saint Clair Shores, MI
• Providers in Saint Clair Shores, MI by specialty
• Clinical Psychologist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2024; 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.