NPIMap

Organization Active NPI

Spectrum Rehabilitation Centers Inc

  • Clinical Neuropsychologist
  • Southfield, MI
National Provider Identifier
1215928643
Registry record updated May 24, 2021
On this page

Key facts

NPPES NPI Registry
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
Last updated
May 24, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 24, 2021

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

Authorized official

Name
Dr. Bradley G Sewick, PHDNPI 1801935549
Title
Owner
Phone
(248) 350-3650

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical NeuropsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103G00000X 6301005256 MI Primary

Addresses

Primary practice location

26555 Evergreen Rd
Ste 830
Southfield, MI 48076-4206

Mailing address

26555 Evergreen Rd
Ste 830
Southfield, MI 48076-4206
Phone (248) 350-3650

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southfield, MI

Sources for this page

  • 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.