Individual provider Active NPI

David M Ledgerwood, PHD

  • Psychologist
  • Detroit, MI
National Provider Identifier
1376742056
Registry record updated Jul 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
6301013525 Issued in MI
Practice address
3901 Chrysler Dr Ste 1a
Detroit, MI 48201-2167
Phone
(313) 993-3964
NPI assigned
Jul 13, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 6301013525 MI Primary

Addresses

Primary practice location

3901 Chrysler Dr Ste 1a
Detroit, MI 48201-2167

Mailing address

400 Mack Ave
Detroit, MI 48201-2136

Other practice location 1

3901 Chrysler Service Dr
Tolan Park
Detroit, MI 48201-2167
Phone (313) 993-3964

Other practice location 2

3901 Chrysler Dr Ste 3B
Detroit, MI 48201-2167
Phone (313) 577-1396

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

Practice roles

OrganizationSpecialtyStatusNew patients
University Physician Group PastSince Jul 1, 2026 Accepting new patients
University Physician Group Psychologist Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1184284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783468800000",
    "number": "1376742056",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 MACK AVE",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482012136"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3901 CHRYSLER DR STE 1A",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482012167",
            "telephone_number": "313-993-3964"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3901 Chrysler Service Dr",
            "address_2": "Tolan Park",
            "address_purpose": "LOCATION",
            "city": "Detroit",
            "state": "MI",
            "postal_code": "482012167",
            "country_code": "US",
            "telephone_number": "313-993-3964",
            "fax_number": "313-993-1372",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3901 Chrysler Dr Ste 3B",
            "address_purpose": "LOCATION",
            "city": "Detroit",
            "state": "MI",
            "postal_code": "482012167",
            "country_code": "US",
            "telephone_number": "313-577-1396",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEDGERWOOD",
        "first_name": "DAVID",
        "middle_name": "M",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-13",
        "last_updated": "2026-07-08",
        "certification_date": "2026-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MI",
            "license": "6301013525",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

Verify at the official NPI Registry.