Active NPI
Douglas James Pryor, MA LLP CAC II
- Psychologist
- Canton, MI
National Provider Identifier
1174558233
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- Practice address
- 43825 Michigan Ave
Oakdale Recovery Center
Canton, MI 48188 - Phone
- (734) 397-3088
- Fax
- (734) 397-2892
- NPI assigned
- Jul 11, 2006
- 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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | MI | Primary |
Addresses
Primary practice location
43825 Michigan Ave
Oakdale Recovery Center
Canton, MI 48188
Mailing address
1841 19TH St
Wyandette, MI 48192
Phone (734) 283-8135
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
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 301007227 | MI | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152576000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1174558233",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1841 19TH ST",
"city": "WYANDETTE",
"state": "MI",
"postal_code": "48192",
"telephone_number": "734-283-8135"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "43825 MICHIGAN AVE",
"address_2": "OAKDALE RECOVERY CENTER",
"city": "CANTON",
"state": "MI",
"postal_code": "48188",
"telephone_number": "734-397-3088",
"fax_number": "734-397-2892"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PRYOR",
"first_name": "DOUGLAS",
"middle_name": "JAMES",
"name_prefix": "Mr.",
"credential": "MA LLP CAC II",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-11",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "MI",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Canton, MI
- Professional Care Therapy Services PLLC
- Progressive Medical Equipment & Supplies, Inc
- Provide America LC
- Provider Service Organization
- Pryde Physical Therapy PLLC
- Lucinda Pryor
- Colleen M Przybyla, M.S. CCC-SLP
- Louis Mark Przybylski, M.A.
- Psychiatric Consulting Services PC
- Psychiatric Support Services PLLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.