Individual provider Active NPI

Gerald E Poirier, MA LLP

  • Psychologist
  • Warren, MI
National Provider Identifier
1205160934
Registry record updated Sep 29, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
6301006364 Issued in MI
Practice address
11022 Sunburst Ave
Warren, MI 48089-1040
Phone
(586) 758-1084
NPI assigned
Sep 29, 2009
Last updated
Sep 29, 2009By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 29, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 6301006364 MI Primary

Addresses

Primary practice location

11022 Sunburst Ave
Warren, MI 48089-1040

Mailing address

11022 Sunburst Ave
Warren, MI 48089-1040
Phone (586) 758-1084

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

LicenseStateTypeSpecialty
6301006364MIMDPsychologist

NPI Registry JSON

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

{
    "created_epoch": "1254182400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1254182400000",
    "number": "1205160934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11022 SUNBURST AVE",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480891040",
            "telephone_number": "586-758-1084"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11022 SUNBURST AVE",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480891040",
            "telephone_number": "586-758-1084"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POIRIER",
        "first_name": "GERALD",
        "middle_name": "E",
        "name_prefix": "Mr.",
        "credential": "MA LLP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-09-29",
        "last_updated": "2009-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MI",
            "license": "6301006364",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Warren, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2009; 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.