Active NPI
Mary Brennan
- School Psychologist
- Farmington Hills, MI
National Provider Identifier
1356770432
On this page
Key facts
NPPES NPI Registry- Primary specialty
- School Psychologist
- License
- SP0000000827920
- Practice address
- 29887 W 11 Mile Rd
Farmington Hills, MI 48336-1309 - Phone
- (248) 474-4701
- Fax
- (248) 474-1518
- NPI assigned
- Nov 8, 2013
- 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 |
|---|---|---|---|---|
| School Psychologist | 103TS0200X | SP0000000827920 | MI | Primary |
Addresses
Primary practice location
29887 W 11 Mile Rd
Farmington Hills, MI 48336-1309
Mailing address
1250 Laguna CT
Lake Orion, MI 48359-2423
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 |
|---|---|---|---|
| SP0000000827920 | MI | MD | School Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1383868800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1383868800000",
"number": "1356770432",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1250 LAGUNA CT",
"city": "LAKE ORION",
"state": "MI",
"postal_code": "483592423"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "29887 W 11 MILE RD",
"city": "FARMINGTON HILLS",
"state": "MI",
"postal_code": "483361309",
"telephone_number": "248-474-4701",
"fax_number": "248-474-1518"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRENNAN",
"first_name": "MARY",
"name_prefix": "Mrs.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-11-08",
"last_updated": "2013-11-08",
"status": "A"
},
"taxonomies": [
{
"code": "103TS0200X",
"taxonomy_group": "",
"desc": "Psychologist, School",
"state": "MI",
"license": "SP0000000827920",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Farmington Hills, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.