Active NPI
Shannon Sugarman
- Clinical Psychologist
- Inkster, MI
National Provider Identifier
1316311426
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 6301016434
- Practice address
- 30000 Hiveley St
Inkster, MI 48141-1089 - Phone
- (734) 721-7310
- NPI assigned
- Dec 1, 2015
- Last updated
- Dec 1, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 6301016434 | MI | Primary |
Addresses
Primary practice location
30000 Hiveley St
Inkster, MI 48141-1089
Mailing address
2005 Planavon St Apt 2
Ferndale, MI 48220-2908
Phone (248) 444-6978
Other names 1
- Shannon Marie Breisacher
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6301016434 | MI | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Shannon Sugarman Psychotherapy | Current | Accepting new patients |
Locations
27655 Middlebelt Rd
Ste 140
Farmington Hills, MI 48334
Phone (248) 444-6978
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Adult Mental Health Clinic/Center
- Farmington Hills, MI
- NPI 1881229151
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1448928000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1448928000000",
"number": "1316311426",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2005 PLANAVON ST APT 2",
"city": "FERNDALE",
"state": "MI",
"postal_code": "482202908",
"telephone_number": "248-444-6978"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "30000 HIVELEY ST",
"city": "INKSTER",
"state": "MI",
"postal_code": "481411089",
"telephone_number": "734-721-7310"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SUGARMAN",
"first_name": "SHANNON",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-12-01",
"last_updated": "2015-12-01",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "MI",
"license": "6301016434",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "SHANNON",
"last_name": "BREISACHER",
"middle_name": "MARIE",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Inkster, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.