Individual provider Active NPI

John F Pascaretti, MA, LLP, CAADC

  • Clinical Psychologist
  • Mount Clemens, MI
National Provider Identifier
1205984887
Registry record updated Sep 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
6301010476 Issued in MI
Practice address
175 N Groesbeck Hwy
Mount Clemens, MI 48043-1562
Phone
(810) 241-4699
NPI assigned
Jan 8, 2007
Last updated
Sep 15, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 15, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 6361002554 MI
Clinical Psychologist 103TC0700X 6301010476 MI Primary

Addresses

Primary practice location

175 N Groesbeck Hwy
Mount Clemens, MI 48043-1562

Mailing address

175 N Groesbeck Hwy
Mount Clemens, MI 48043-1562
Phone (810) 241-4699

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)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
6301010476MIMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1168214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631664000000",
    "number": "1205984887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "175 N GROESBECK HWY",
            "city": "MOUNT CLEMENS",
            "state": "MI",
            "postal_code": "480431562",
            "telephone_number": "810-241-4699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "175 N GROESBECK HWY",
            "city": "MOUNT CLEMENS",
            "state": "MI",
            "postal_code": "480431562",
            "telephone_number": "810-241-4699"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PASCARETTI",
        "first_name": "JOHN",
        "middle_name": "F",
        "name_prefix": "Mr.",
        "credential": "MA, LLP, CAADC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-08",
        "last_updated": "2021-09-15",
        "certification_date": "2021-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6361002554",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6301010476",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Clemens, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2021; 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.