NPIMap

Organization Active NPI

United Psychological Services Inc

  • Clinical Neuropsychologist
  • Shelby TWP, MI
National Provider Identifier
1407947658
Registry record updated Nov 21, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
6301002997 Issued in MI
Legal business name
UNITED PSYCHOLOGICAL SERVICES INC
Practice address
47818 Van Dyke Ave
Shelby TWP, MI 48317-3373
Phone
(586) 323-3620
Fax
(586) 323-3568
NPI assigned
Sep 27, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2007

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

Authorized official

Name
Barbara C Fisher, PHDNPI 1245458280
Title
Owner
Phone
(586) 677-1590

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical NeuropsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103G00000X 6301002997 MI Primary

Addresses

Primary practice location

47818 Van Dyke Ave
Shelby TWP, MI 48317-3373

Mailing address

59100 Mound Rd
Washington, MI 48094-2039
Phone (586) 677-1590

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20071129000492 MI Part B Supplier - Clinic/Group Practice 8921197807 Receives reassigned benefits from 7 practitioners
Practice locations: Shelby TWP, MI

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 28

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

View all 28

NPI Registry JSON

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

{
    "created_epoch": "1159315200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1195603200000",
    "number": "1407947658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "59100 MOUND RD",
            "city": "WASHINGTON",
            "state": "MI",
            "postal_code": "480942039",
            "telephone_number": "586-677-1590",
            "fax_number": "586-677-1591"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "47818 VAN DYKE AVE",
            "city": "SHELBY TWP",
            "state": "MI",
            "postal_code": "483173373",
            "telephone_number": "586-323-3620",
            "fax_number": "586-323-3568"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNITED PSYCHOLOGICAL SERVICES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-27",
        "last_updated": "2007-11-21",
        "status": "A",
        "authorized_official_last_name": "FISHER",
        "authorized_official_first_name": "BARBARA",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "586-677-1590",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Clinical Neuropsychologist",
            "state": "MI",
            "license": "6301002997",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shelby TWP, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2007; 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.