Individual provider Active NPI

Cynthia Ann Palmer-Hughes, PHD

  • Clinical Psychologist
  • Grosse Pointe Park, MI
National Provider Identifier
1356482319
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
6301008858 Issued in MI
Practice address
15450 E Jefferson Ave Ste 120
Grosse Pointe Park, MI 48230-2028
Phone
(313) 824-7102
NPI assigned
Feb 10, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 6301008858 MI Primary

Addresses

Primary practice location

15450 E Jefferson Ave Ste 120
Grosse Pointe Park, MI 48230-2028

Mailing address

15450 E Jefferson Ave Ste 120
Grosse Pointe Park, MI 48230-2028
Phone (313) 824-7102

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)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
6301008858MIMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1171065600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1356482319",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15450 E JEFFERSON AVE STE 120",
            "city": "GROSSE POINTE PARK",
            "state": "MI",
            "postal_code": "482302028",
            "telephone_number": "313-824-7102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15450 E JEFFERSON AVE STE 120",
            "city": "GROSSE POINTE PARK",
            "state": "MI",
            "postal_code": "482302028",
            "telephone_number": "313-824-7102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PALMER-HUGHES",
        "first_name": "CYNTHIA",
        "middle_name": "ANN",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6301008858",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grosse Pointe Park, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.