Gary Joseph Fusciardi, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

6301005314 Issued in MI

Practice address

8061 21 Mile Rd
Suite #4
Shelby Township, MI 48317-4311

Phone

(586) 323-0696

Fax

(586) 731-8393

NPI assigned

Mar 18, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1142640000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1245299361",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "52480 SHELBY RD",
            "city": "SHELBY TOWNSHIP",
            "state": "MI",
            "postal_code": "483163163",
            "telephone_number": "586-323-0696",
            "fax_number": "586-731-8393"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8061 21 MILE RD",
            "address_2": "SUITE #4",
            "city": "SHELBY TOWNSHIP",
            "state": "MI",
            "postal_code": "483174311",
            "telephone_number": "586-323-0696",
            "fax_number": "586-731-8393"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FUSCIARDI",
        "first_name": "GARY",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6301005314",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5088220",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUE OPTIONS",
            "identifier": "042893",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Skyla Renee Freed
• Tiara D Friedman
• Lynn Kristine Fritz, LMT
• Lin Fu, NP
• Matthew James Furtah, RBT
• Bethany Jean Gadd, MSN, RN, FNP-BC
• David Joseph Gadioli, DDS
• Julia Gage, FNP-BC
• Rasha Gagi
• Amanda Gahan

• Clinical Psychologist in Shelby Township, MI
• Providers in Shelby Township, MI by specialty
• Clinical Psychologist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.