NPIMap

Organization Active NPI

University of Michigan Psychological Clinic

  • Psychologist
  • Ann Arbor, MI
National Provider Identifier
1427229095
Registry record updated Jul 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
Legal business name
UNIVERSITY OF MICHIGAN PSYCHOLOGICAL CLINIC
Practice address
210 S 5TH Ave
Ann Arbor, MI 48104
Phone
(734) 615-7853
Fax
(734) 764-8128
NPI assigned
Mar 21, 2008
Last updated
Jul 25, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
REGENTS OF THE UNIVERSITY OF MICHIGANAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 25, 2024

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

Authorized official

Name
Meagjan Fesler, M.S. , LLP
Title
Clinic and Operations Manager
Phone
(734) 764-2961

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Mental Health Clinic/Center 261QM0850X NU
Psychologist 103T00000X NU Primary
Clinical Social Worker 1041C0700X NU

Addresses

Primary practice location

210 S 5TH Ave
Ann Arbor, MI 48104

Mailing address

210 S 5TH Ave
Ann Arbor, MI 48104
Phone (734) 615-7853

Other identifiers 1

IdentifierTypeStateIssuer
1518065986OtherMINPPES

Other names 1

  • The Psychological Clinic Other name

National Provider Directory

National Provider Directory
Tax ID family
Regents of the University of Michigan-Psychological Clinic2 organizations share this tax ID, including this one
Part of
Chelsea Internal Medici

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

210 S 5th Ave
Ann Arbor, MI 48104
Phone (734) 615-7853

Practitioners & affiliated clinicians

Practitioners 70

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 70

NPI Registry JSON

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

{
    "created_epoch": "1206057600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721865600000",
    "number": "1427229095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 S 5TH AVE",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "48104",
            "telephone_number": "734-615-7853",
            "fax_number": "734-764-8128"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 S 5TH AVE",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "48104",
            "telephone_number": "734-615-7853",
            "fax_number": "734-764-8128"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIVERSITY OF MICHIGAN PSYCHOLOGICAL CLINIC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "REGENTS OF THE UNIVERSITY OF MICHIGAN",
        "enumeration_date": "2008-03-21",
        "last_updated": "2024-07-25",
        "status": "A",
        "authorized_official_last_name": "FESLER",
        "authorized_official_first_name": "MEAGJAN",
        "authorized_official_title_or_position": "CLINIC AND OPERATIONS MANAGER",
        "authorized_official_telephone_number": "734-764-2961",
        "authorized_official_credential": "M.S. , LLP"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPPES",
            "identifier": "1518065986",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Psychological Clinic",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "The Psychological Clinic",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Ann Arbor, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.