Organization Active NPI

Scheerbert Psychological, PLLC

  • Clinical Psychologist
  • Southfield, MI
National Provider Identifier
1225255771
Registry record updated May 10, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
6301006332 Issued in MI
Legal business name
SCHEERBERT PSYCHOLOGICAL, PLLC
Practice address
25899 W 12 Mile Rd
Suite 190
Southfield, MI 48034-1800
Phone
(248) 415-4471
Fax
(248) 809-6245
NPI assigned
Apr 19, 2007
Last updated
May 10, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 10, 2017

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

Authorized official

Name
Thomas Alan Hulbert, PH.D.NPI 1841273570
Title
President
Phone
(248) 415-4471

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 6301006332 MI Primary

Addresses

Primary practice location

25899 W 12 Mile Rd
Suite 190
Southfield, MI 48034-1800

Mailing address

25899 W 12 Mile Rd
Suite 190
Southfield, MI 48034-1800
Phone (248) 415-4471

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080130000056 MI Part B Supplier - Clinic/Group Practice 6507948585 Receives reassigned benefits from 1 practitioner
Practice locations: Grosse Pointe, MI; Southfield, MI

National Provider Directory

National Provider Directory
Tax ID family
Scheerbert Psychological PLLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

18090 Mack Ave
Ste 4
Grosse Pointe, MI 48230
Phone (248) 415-4471

25899 W 12 Mile Rd
Ste 1
Southfield, MI 48034

Practitioners & affiliated clinicians

Practitioners 1

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": "1176940800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1494374400000",
    "number": "1225255771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25899 W 12 MILE RD",
            "address_2": "SUITE 190",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480341800",
            "telephone_number": "248-415-4471",
            "fax_number": "248-809-6245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25899 W 12 MILE RD",
            "address_2": "SUITE 190",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480341800",
            "telephone_number": "248-415-4471",
            "fax_number": "248-809-6245"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SCHEERBERT PSYCHOLOGICAL, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-19",
        "last_updated": "2017-05-10",
        "status": "A",
        "authorized_official_last_name": "HULBERT",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "ALAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "248-415-4471",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6301006332",
            "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 10, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.