Bruce Ray Anderson, LLP

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

6301006766 Issued in MI

Practice address

4925 Packard St
Ann Arbor, MI 48108-1521

Phone

(734) 971-9781

NPI assigned

Jul 29, 2010

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Catholic Social Services of Washtenaw County

  • Voluntary or Charitable Agency
  • Ann Arbor, MI
  • NPI 1679687339
  NPD

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

{
    "created_epoch": "1280361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700524800000",
    "number": "1447564745",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4925 PACKARD ST",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481081521",
            "telephone_number": "734-971-9781"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4925 PACKARD ST",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481081521",
            "telephone_number": "734-971-9781"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "BRUCE",
        "middle_name": "RAY",
        "name_prefix": "Mr.",
        "credential": "LLP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-07-29",
        "last_updated": "2023-11-21",
        "certification_date": "2023-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6301006766",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emily Amherst Andersen
• Laura Elizabeth Andersen, M.D.
• Melissa Nicole Andersen, PHD
• Adam Anderson
• Amanda Anderson
• Christine Marie Anderson, MD
• Daniel Edward Anderson, LMSW
• Donald Anderson Jr.
• Douglas Henry Anderson, MD
• Douglas Wyatt Anderson, MD

• Clinical Psychologist in Ann Arbor, MI
• Providers in Ann Arbor, MI by specialty
• Clinical Psychologist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2023; 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.