Individual provider Active NPI

Shari Jill Dobrusin, PHD

  • Mental Health Counselor
  • Bloomfield Hills, MI
National Provider Identifier
1417070467
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
6301008376 Issued in MI
Practice address
4225 Sandy LN
Bloomfield Hills, MI 48301-1502
Phone
(248) 865-2807
NPI assigned
Apr 6, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 6301008376 MI Primary

Addresses

Primary practice location

4225 Sandy LN
Bloomfield Hills, MI 48301-1502

Mailing address

4225 Sandy LN
Bloomfield Hills, MI 48301-1502
Phone (248) 865-2807

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210615000261 MI Practitioner - Clinical Psychologist 9335549203 Practice locations: Bloomfield Hills, MI

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4120 W Maple Rd
Suite 101
Bloomfield Hills, MI 48301-3014
Phone (248) 255-6292

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
6301008376MIMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Shari Dobrusin PH.D. CurrentSince Jan 19, 2022 Accepting new patients

Locations

6443 Inkster Rd
Ste 290
Bloomfield Hills, MI 48301
Phone (248) 255-6292

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1175817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1417070467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4225 SANDY LN",
            "city": "BLOOMFIELD HILLS",
            "state": "MI",
            "postal_code": "483011502",
            "telephone_number": "248-865-2807"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4225 SANDY LN",
            "city": "BLOOMFIELD HILLS",
            "state": "MI",
            "postal_code": "483011502",
            "telephone_number": "248-865-2807"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOBRUSIN",
        "first_name": "SHARI",
        "middle_name": "JILL",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MI",
            "license": "6301008376",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomfield Hills, MI

Sources for this page

Verify at the official NPI Registry.