Individual provider Active NPI

Rachael Lauren Les

  • Clinical Psychologist
  • Birmingham, MI
National Provider Identifier
1336837632
Registry record updated May 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
6362009734 Issued in MI
Practice address
700 E Maple Rd
Birmingham, MI 48009-6357
Phone
(248) 792-1097
NPI assigned
Apr 26, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 21, 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 6362009734 MI Primary

Addresses

Primary practice location

700 E Maple Rd
Birmingham, MI 48009-6357

Mailing address

1294 S Creek Dr
Wixom, MI 48393-1678

Other practice location 1

120 W Main St
Northville, MI 48167-1586
Phone (248) 792-1097

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

LicenseStateTypeSpecialty
6362009734MIMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1682467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684627200000",
    "number": "1336837632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1294 S CREEK DR",
            "city": "WIXOM",
            "state": "MI",
            "postal_code": "483931678"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 E MAPLE RD",
            "city": "BIRMINGHAM",
            "state": "MI",
            "postal_code": "480096357",
            "telephone_number": "248-792-1097"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "120 W Main St",
            "address_purpose": "LOCATION",
            "city": "Northville",
            "state": "MI",
            "postal_code": "481671586",
            "country_code": "US",
            "telephone_number": "248-792-1097",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LES",
        "first_name": "RACHAEL",
        "middle_name": "LAUREN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-04-26",
        "last_updated": "2023-05-21",
        "certification_date": "2023-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6362009734",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Birmingham, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 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.