Active NPI
Susan D Silk, PHD
- Clinical Psychologist
- Southfield, MI
National Provider Identifier
1376758623
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 6301003963
- Practice address
- 26645 W 12 Mile Rd
Ste 104
Southfield, MI 48034 - Phone
- (248) 350-9890
- NPI assigned
- May 11, 2007
- 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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 6301003963 | MI | Primary |
Addresses
Primary practice location
26645 W 12 Mile Rd
Ste 104
Southfield, MI 48034
Mailing address
6620 Halyard
Bloomfield TWP, MI 48301
Phone (248) 932-9933
Medicare participation
Medicare enrollment files- 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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20050509000306 | MI | Practitioner - Clinical Psychologist | 8224078308 | Practice locations: Pontiac, MI; Southfield, MI |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Wayne State University School of Medicine, 1979
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
26645 W 12 Mile Rd
Southfield, MI 48034-7811
Phone (248) 350-9890
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6301003963 | MI | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1178841600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1376758623",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6620 HALYARD",
"city": "BLOOMFIELD TWP",
"state": "MI",
"postal_code": "48301",
"telephone_number": "248-932-9933",
"fax_number": "248-932-2831"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "26645 W 12 MILE RD",
"address_2": "STE 104",
"city": "SOUTHFIELD",
"state": "MI",
"postal_code": "48034",
"telephone_number": "248-350-9890"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SILK",
"first_name": "SUSAN",
"middle_name": "D",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-05-11",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "MI",
"license": "6301003963",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Southfield, 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.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.