Individual provider Active NPI

Patrick David Rivard, PH.D.

  • Clinical Psychologist
  • Sterling Heights, MI
National Provider Identifier
1205271822
Registry record updated May 9, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
6301015252 Issued in MI
Practice address
8530 Clinton River Rd
Sterling Heights, MI 48314-1627
Phone
(586) 739-3680
NPI assigned
May 9, 2013
Last updated
May 9, 2013By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 9, 2013

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

Specialties & licenses 10

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 6301015252 MI
Psychologist 103T00000X 6301015252 MI
Cognitive & Behavioral Psychologist 103TB0200X 6301015252 MI
Clinical Psychologist 103TC0700X 6301015252 MI Primary
Clinical Child & Adolescent Psychologist 103TC2200X 6301015252 MI
Intellectual & Developmental Disabilities Psychologist 103TM1800X 6301015252 MI
Group Psychotherapy Psychologist 103TP2701X 6301015252 MI
School Psychologist 103TS0200X 179302 MI
Social Worker 104100000X 6801013804 MI
Clinical Social Worker 1041C0700X 6801013804 MI

Addresses

Primary practice location

8530 Clinton River Rd
Sterling Heights, MI 48314-1627

Mailing address

8530 Clinton River Rd
Sterling Heights, MI 48314-1627
Phone (586) 739-3680

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
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
6301015252MIMDClinical Psychologist
179302MIMDSchool Psychologist
6801013804MIMDSocial Worker

NPI Registry JSON

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

{
    "created_epoch": "1368057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1368057600000",
    "number": "1205271822",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8530 CLINTON RIVER RD",
            "city": "STERLING HEIGHTS",
            "state": "MI",
            "postal_code": "483141627",
            "telephone_number": "586-739-3680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8530 CLINTON RIVER RD",
            "city": "STERLING HEIGHTS",
            "state": "MI",
            "postal_code": "483141627",
            "telephone_number": "586-739-3680"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIVARD",
        "first_name": "PATRICK",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-05-09",
        "last_updated": "2013-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MI",
            "license": "6301015252",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MI",
            "license": "6301015252",
            "primary": false
        },
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": "MI",
            "license": "6301015252",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6301015252",
            "primary": true
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "MI",
            "license": "6301015252",
            "primary": false
        },
        {
            "code": "103TM1800X",
            "taxonomy_group": "",
            "desc": "Psychologist, Intellectual & Developmental Disabilities",
            "state": "MI",
            "license": "6301015252",
            "primary": false
        },
        {
            "code": "103TP2701X",
            "taxonomy_group": "",
            "desc": "Psychologist, Group Psychotherapy",
            "state": "MI",
            "license": "6301015252",
            "primary": false
        },
        {
            "code": "103TS0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, School",
            "state": "MI",
            "license": "179302",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MI",
            "license": "6801013804",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801013804",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sterling Heights, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2013; 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.