Individual provider Active NPI

Supriya Davina Singh, MA, MLP

  • Clinical Psychologist
  • Troy, MI
National Provider Identifier
1225646326
Registry record updated Jun 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
6362008877 Issued in MI
Practice address
1777 Axtell Dr Ste 100
Troy, MI 48084-4400
Phone
(248) 787-0855
Fax
(248) 398-1193
NPI assigned
Jul 15, 2020
Last updated
Jun 26, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 26, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 6362008877 MI Primary

Addresses

Primary practice location

1777 Axtell Dr Ste 100
Troy, MI 48084-4400

Mailing address

1946 Leader Dr. Apartment 202
Rochester Hills, MI 48307
Phone (248) 229-2518

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
Master of Arts

State licenses

LicenseStateTypeSpecialty
6362008877MIMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1594771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687737600000",
    "number": "1225646326",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1946 LEADER DR. APARTMENT 202",
            "city": "ROCHESTER HILLS",
            "state": "MI",
            "postal_code": "48307",
            "telephone_number": "248-229-2518"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1777 AXTELL DR STE 100",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480844400",
            "telephone_number": "248-787-0855",
            "fax_number": "248-398-1193"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SINGH",
        "first_name": "SUPRIYA",
        "middle_name": "DAVINA",
        "credential": "MA, MLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-07-15",
        "last_updated": "2023-06-26",
        "certification_date": "2023-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6362008877",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Troy, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2023; 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.