Individual provider Active NPI

Janis Haggerty, M.S.

  • Clinical Psychologist
  • Livonia, MI
National Provider Identifier
1285075291
Registry record updated Jul 8, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
6301015533 Issued in MI
Practice address
17177 N Laurel Park Dr
#131
Livonia, MI 48152-2693
Phone
(734) 462-3210
NPI assigned
Jul 8, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2013

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 6301015533 MI Primary

Addresses

Primary practice location

17177 N Laurel Park Dr
#131
Livonia, MI 48152-2693

Mailing address

8777 Columbia Cir
Canton, MI 48187-1354
Phone (734) 634-1647

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190124003708 MI Practitioner - Psychologist Billing Independently 1355688607 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

Practice roles

OrganizationSpecialtyStatusNew patients
Victor M. Cruz MD, P.C. CurrentSince Jan 1, 2019 Accepting new patients

Locations

17177 Laurel Dr
Ste 131
Livonia, MI 48152
Phone (313) 462-3210

17177 N Laurel Park Dr
Ste 131
Livonia, MI 48152
Phone (734) 462-3210

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1373241600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1373241600000",
    "number": "1285075291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8777 COLUMBIA CIR",
            "city": "CANTON",
            "state": "MI",
            "postal_code": "481871354",
            "telephone_number": "734-634-1647"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17177 N LAUREL PARK DR",
            "address_2": "#131",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481522693",
            "telephone_number": "734-462-3210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAGGERTY",
        "first_name": "JANIS",
        "credential": "M.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-08",
        "last_updated": "2013-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6301015533",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Livonia, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2013; 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.