Individual provider Active NPI

Terry Jacob Thomas, TLLP

  • Clinical Psychologist
  • Westland, MI
National Provider Identifier
1346064540
Registry record updated Nov 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
6362010058 Issued in MI
Practice address
33298 Trafalgar SQ Apt 5
Westland, MI 48186-4860
Phone
(313) 957-8478
NPI assigned
Nov 13, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2024

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 6362010058 MI Primary

Addresses

Primary practice location

33298 Trafalgar SQ Apt 5
Westland, MI 48186-4860

Mailing address

33298 Trafalgar SQ Apt 5
Westland, MI 48186-4860
Phone (313) 957-8478

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
6362010058MIMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1731456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731456000000",
    "number": "1346064540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33298 TRAFALGAR SQ APT 5",
            "city": "WESTLAND",
            "state": "MI",
            "postal_code": "481864860",
            "telephone_number": "313-957-8478"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33298 TRAFALGAR SQ APT 5",
            "city": "WESTLAND",
            "state": "MI",
            "postal_code": "481864860",
            "telephone_number": "313-957-8478"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMAS",
        "first_name": "TERRY",
        "middle_name": "JACOB",
        "credential": "TLLP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-11-13",
        "last_updated": "2024-11-13",
        "certification_date": "2024-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6362010058",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Westland, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2024; 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.