Individual provider Active NPI

Marc Robert Hirsch, PH.D.

  • Clinical Psychologist
  • Farmington Hills, MI
National Provider Identifier
1184766388
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
6301005297 Issued in MI
Practice address
31731 Northwestern Hwy
Suite 257W
Farmington Hills, MI 48334-1654
Phone
(248) 737-7860
NPI assigned
Feb 13, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 6301005297 MI Primary

Addresses

Primary practice location

31731 Northwestern Hwy
Suite 257W
Farmington Hills, MI 48334-1654

Mailing address

31731 Northwestern Hwy
Suite 257W
Farmington Hills, MI 48334-1654
Phone (248) 737-7860

Other identifiers 1

IdentifierTypeStateIssuer
0F34898OtherMIBLUE CROSS BLUE SHIELD

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
I20120705000262 MI Practitioner - Clinical Psychologist 8123283702 Practice locations: Farmington Hills, MI

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

31731 Northwestern Hwy
Suite 110E
Farmington Hills, MI 48334-1654
Phone (248) 613-9001

31731 Northwestern Hwy
Suite 257W
Farmington Hills, MI 48334-1668

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
6301005297MIMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1171324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1184766388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31731 NORTHWESTERN HWY",
            "address_2": "SUITE 257W",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483341654",
            "telephone_number": "248-737-7860"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31731 NORTHWESTERN HWY",
            "address_2": "SUITE 257W",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483341654",
            "telephone_number": "248-737-7860"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HIRSCH",
        "first_name": "MARC",
        "middle_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6301005297",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "0F34898",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Farmington Hills, MI

Sources for this page

Verify at the official NPI Registry.