Demetrius Edwin Ford, LP, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

6301018364 Issued in MI

Practice address

21 Kercheval Ave Ste 371
Grosse Pointe Farms, MI 48236-3698

Phone

(313) 806-9535

NPI assigned

Jan 26, 2007

Last updated

Jun 10, 2025By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

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.

• Henry Ford Health Eastwood Behavioral Health

  dba Eastwood Clinics

  • Social Worker
  • Clinton Township, MI
  • NPI 1396787701
  Medicare reassignment NPD
• Social Care Administrators LLC

  dba McCrory Center

  • Case Management Agency
  • Detroit, MI
  • NPI 1487916433
  Medicare reassignment NPD
• Triton Behavorial Health LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Dearborn Heights, MI
  • NPI 1205337722
  Medicare reassignment NPD
• Platinum Psychological Services LLC

  • Clinical Psychologist
  • Grosse Pointe Farms, MI
  • NPI 1891245775
  NPD Authorized official

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

{
    "created_epoch": "1169769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749513600000",
    "number": "1376699801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 KERCHEVAL AVE STE 317",
            "city": "GROSSE POINTE FARMS",
            "state": "MI",
            "postal_code": "482363698",
            "telephone_number": "313-806-9535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 KERCHEVAL AVE STE 371",
            "city": "GROSSE POINTE FARMS",
            "state": "MI",
            "postal_code": "482363698",
            "telephone_number": "313-806-9535"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "22151 Moross",
            "address_2": "Professional Building 1 Suite 334",
            "address_purpose": "LOCATION",
            "city": "Detroit",
            "state": "MI",
            "postal_code": "482362196",
            "country_code": "US",
            "telephone_number": "313-343-7230",
            "fax_number": "313-343-7449",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FORD",
        "first_name": "DEMETRIUS",
        "middle_name": "EDWIN",
        "credential": "LP, PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-26",
        "last_updated": "2025-06-10",
        "certification_date": "2025-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MI",
            "license": "6301009054",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6301018364",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ashley Nicole Falco, M.D.
• Victoria Kathleen Helen Fawaz, NP
• Travis Michael Fields, PT, DPT
• Leo Fisher
• Jillian Flint
• Kelly Gaffney
• Elizabeth D. Garcia, LMSW
• Gary a. Shoemaker, D.C. P.C. (Clairpointe Family Chiropractic)
• Lucas Matthew Gelmini, DO
• Judy Gilbert, LLP

• Clinical Psychologist in Grosse Pointe Farms, MI
• Providers in Grosse Pointe Farms, MI by specialty
• Clinical Psychologist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.