Individual provider Active NPI

Karen Anne Schurgin, MA PSY S

  • Clinical Psychologist
  • Farmington Hills, MI
National Provider Identifier
1417150889
Registry record updated May 21, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
6301014092 Issued in MI
Practice address
29887 W Eleven Mile Rd
Farmington Hills, MI 48336-1309
Phone
(248) 474-4701
Fax
(248) 474-1518
NPI assigned
Jun 6, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 21, 2012

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X LMHC MH3449 FL
Professional Counselor 101YP2500X LPC6401008439 MI
Clinical Psychologist 103TC0700X 6301014092 MI Primary

Addresses

Primary practice location

29887 W Eleven Mile Rd
Farmington Hills, MI 48336-1309

Mailing address

4517 Kevin CT
W Bloomfield, MI 48322-1606
Phone (248) 931-3719

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
I20121106000607 MI Practitioner - Clinical Psychologist 4880845528 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

29887 W 11 Mile Rd
Farmington Hills, MI 48336-1309
Phone (248) 474-4701

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
LMHC MH3449FLMDMental Health Counselor
LPC6401008439MIMDProfessional Counselor
6301014092MIMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Samaritan Counseling Center Current Accepting new patients
Samaritan Counseling Center of Southeastern Michigan CurrentSince Oct 9, 2012 Accepting new patients

Locations

29887 W 11 Mile Rd
Farmington Hills, MI 48336
Phone (248) 476-8860

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": "1181088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1337558400000",
    "number": "1417150889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4517 KEVIN CT",
            "city": "W BLOOMFIELD",
            "state": "MI",
            "postal_code": "483221606",
            "telephone_number": "248-931-3719"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29887 W ELEVEN MILE RD",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483361309",
            "telephone_number": "248-474-4701",
            "fax_number": "248-474-1518"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHURGIN",
        "first_name": "KAREN",
        "middle_name": "ANNE",
        "credential": "MA PSY S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-06",
        "last_updated": "2012-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "LMHC MH3449",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MI",
            "license": "LPC6401008439",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6301014092",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Farmington Hills, MI

Sources for this page

Verify at the official NPI Registry.