Individual provider Active NPI

Sean Domas, PSY.D

  • Psychologist
  • Livonia, MI
National Provider Identifier
1164280970
Registry record updated Mar 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
6351004688 Issued in MI
Practice address
37450 Schoolcraft Rd Ste 110
Livonia, MI 48150-1000
Phone
(734) 395-8404
NPI assigned
Mar 7, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 6351004688 MI Primary

Addresses

Primary practice location

37450 Schoolcraft Rd Ste 110
Livonia, MI 48150-1000

Mailing address

30285 Timberidge Cir Apt 301
Farmington Hills, MI 48336-5454
Phone (734) 395-8404

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

State licenses

LicenseStateTypeSpecialty
6351004688MIMDPsychologist

NPI Registry JSON

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

{
    "created_epoch": "1709769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709769600000",
    "number": "1164280970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30285 TIMBERIDGE CIR APT 301",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483365454",
            "telephone_number": "734-395-8404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "37450 SCHOOLCRAFT RD STE 110",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481501000",
            "telephone_number": "734-395-8404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOMAS",
        "first_name": "SEAN",
        "name_prefix": "Dr.",
        "credential": "PSY.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-03-07",
        "last_updated": "2024-03-07",
        "certification_date": "2024-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MI",
            "license": "6351004688",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Livonia, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 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.