Spectrum Rehabilitation Centers Inc

Primary specialty

Clinical NeuropsychologistTaxonomy code 103G00000X

License

6301005256 Issued in MI

Legal business name

SPECTRUM REHABILITATION CENTERS INC

Practice address

26555 Evergreen Rd
Ste 830
Southfield, MI 48076-4206

Phone

(248) 350-3650

Fax

(248) 350-1216

NPI assigned

Nov 3, 2005

Organization subpart

No

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

Authorized official

Name

Dr. Bradley G Sewick, PHD

Title

Owner

Phone

(248) 350-3650

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Suzanne Marie Macdonald, LPC, LLP

  • Professional Counselor
  • Southfield, MI
  • NPI 1306559091
  NPD
• Richard Staszkow, PH.D.

  • Psychologist
  • Southfield, MI
  • NPI 1225703069
  NPD

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

{
    "created_epoch": "1130976000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1621814400000",
    "number": "1215928643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26555 EVERGREEN RD",
            "address_2": "STE 830",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480764206",
            "telephone_number": "248-350-3650",
            "fax_number": "248-350-1216"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26555 EVERGREEN RD",
            "address_2": "STE 830",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480764206",
            "telephone_number": "248-350-3650",
            "fax_number": "248-350-1216"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPECTRUM REHABILITATION CENTERS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-03",
        "last_updated": "2021-05-24",
        "certification_date": "2021-05-24",
        "status": "A",
        "authorized_official_last_name": "SEWICK",
        "authorized_official_first_name": "BRADLEY",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "248-350-3650",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Clinical Neuropsychologist",
            "state": "MI",
            "license": "6301005256",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1193960001",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Specialized Care and Housing
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• Specialty Home Health Services, LLC
• Spectrum Physical Therapy LLC
• Speech and Language Solutions LLC
• Speech Works LLC
• Jessica Spence
• Siedah Ladonna Spencer-Ardis, MA, LMFT
• Yolanda D Spencer-Dandridge, LMSW

• Clinical Neuropsychologist in Southfield, MI
• Providers in Southfield, MI by specialty
• Clinical Neuropsychologist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 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.