Individual provider Active NPI

Greg Oliver, LLP

  • Psychologist
  • Dearborn, MI
National Provider Identifier
1194826792
Registry record updated Mar 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
6361001325 Issued in MI
Practice address
5111 Auto Club Dr
112
Dearborn, MI 48126-2749
Phone
(313) 317-2000
Fax
(313) 317-2090
NPI assigned
Sep 26, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Psychologist 103TA0400X
Psychologist 103T00000X 6361001325 MI Primary

Addresses

Primary practice location

5111 Auto Club Dr
112
Dearborn, MI 48126-2749

Mailing address

2825 Livernois Rd
Troy, MI 48083-1214
Phone (248) 680-2060

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address goliver9303@direct.hfhs.org

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
6361001325MIMDPsychologist

Interoperability endpoints

  • Direct secure messaging: goliver9303@direct.hfhs.org

NPI Registry JSON

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

{
    "created_epoch": "1159228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678665600000",
    "number": "1194826792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2825 LIVERNOIS RD",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480831214",
            "telephone_number": "248-680-2060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5111 AUTO CLUB DR",
            "address_2": "112",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481262749",
            "telephone_number": "313-317-2000",
            "fax_number": "313-317-2090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLIVER",
        "first_name": "GREG",
        "credential": "LLP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-26",
        "last_updated": "2023-03-13",
        "certification_date": "2021-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TA0400X",
            "taxonomy_group": "",
            "desc": "Psychologist, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MI",
            "license": "6361001325",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "goliver9303@direct.hfhs.org",
            "affiliation": "N",
            "address_1": "2825 Livernois Rd",
            "city": "Troy",
            "state": "MI",
            "country_code": "US",
            "postal_code": "480831214",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Dearborn, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2023; 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.