Individual provider Active NPI

Denise L Brooks, PSY.D., L.P.

  • Clinical Psychologist
  • Plymouth, MI
National Provider Identifier
1285961532
Registry record updated Mar 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
6301014556 Issued in MI
Practice address
595 Forest Ave
Ste. 7a
Plymouth, MI 48170-1775
Phone
(734) 765-2885
Fax
(734) 446-2716
NPI assigned
Nov 6, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 13, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 6301013975 MI
Clinical Psychologist 103TC0700X 6301014556 MI Primary

Addresses

Primary practice location

595 Forest Ave
Ste. 7a
Plymouth, MI 48170-1775

Mailing address

595 Forest Ave.
Ste. 7a
Plymouth, MI 48170
Phone (734) 765-2885

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120723000947 MI Practitioner - Clinical Psychologist 8224207352 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Stepping Stones Wellness Center PLLCGroup PAC ID 3577850122, 2 clinicians

Practice addresses (Care Compare)

595 Forest Ave
Suite 7a
Plymouth, MI 48170-1777
Phone (734) 446-5466

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6301013975MIMDClinical Psychologist
6301014556MIMDClinical Psychologist

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": "1257465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678665600000",
    "number": "1285961532",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "595 FOREST AVE.",
            "address_2": "STE. 7A",
            "city": "PLYMOUTH",
            "state": "MI",
            "postal_code": "48170",
            "telephone_number": "734-765-2885",
            "fax_number": "734-446-2716"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "595 FOREST AVE",
            "address_2": "STE. 7A",
            "city": "PLYMOUTH",
            "state": "MI",
            "postal_code": "481701775",
            "telephone_number": "734-765-2885",
            "fax_number": "734-446-2716"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROOKS",
        "first_name": "DENISE",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "PSY.D., L.P.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-11-06",
        "last_updated": "2023-03-13",
        "certification_date": "2023-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6301013975",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6301014556",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plymouth, MI

Sources for this page

Verify at the official NPI Registry.