Myrtle C. Means, PH.D., P.C.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

6301011889 Issued in MI

Legal business name

MYRTLE C. MEANS, PH.D., P.C.

Practice address

23003 Greater Mack Ave Ste B
Saint Clair Shores, MI 48080-1965

Phone

(313) 574-6616

NPI assigned

Oct 29, 2007

Organization subpart

No

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

Authorized official

Name

Myrtle Charisse Means, PHDNPI 1710084801

Title

Psychologist

Phone

(313) 574-6616

Specialties & licenses 1

Addresses

Other names 1

• Myrtle C Means PHD PC Other name

Medicare fee-for-service enrollment

Enrolled in MI, GA2 enrollments

Enrollment records 2

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Myrtle Charisse Means, PHD

  • Psychologist
  • Saint Clair Shores, MI
  • NPI 1710084801

  GA

  Medicare reassignment NPD Authorized official
• Christina Haemmerle, PH.D.

  • Psychologist
  • Rochester Hills, MI
  • NPI 1134314529
  NPD (past)

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

{
    "created_epoch": "1193616000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1568160000000",
    "number": "1376722264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11285 ELKINS RD STE D3",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300765835",
            "telephone_number": "313-574-6616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23003 GREATER MACK AVE STE B",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "480801965",
            "telephone_number": "313-574-6616"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "19855 Outer Dr # 103",
            "address_purpose": "LOCATION",
            "city": "Dearborn",
            "state": "MI",
            "postal_code": "481242022",
            "country_code": "US",
            "telephone_number": "313-574-6616",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "11285 Elkins Rd Ste D3",
            "address_purpose": "LOCATION",
            "city": "Roswell",
            "state": "GA",
            "postal_code": "300765835",
            "country_code": "US",
            "telephone_number": "313-574-6616 x2",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MYRTLE C. MEANS, PH.D., P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-29",
        "last_updated": "2019-09-11",
        "status": "A",
        "authorized_official_last_name": "MEANS",
        "authorized_official_first_name": "MYRTLE",
        "authorized_official_middle_name": "CHARISSE",
        "authorized_official_title_or_position": "PSYCHOLOGIST",
        "authorized_official_telephone_number": "313-574-6616",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6301011889",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Myrtle C Means PHD PC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Clinical Psychologist in Saint Clair Shores, MI
• Providers in Saint Clair Shores, MI by specialty
• Clinical Psychologist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.