Individual provider Active NPI

Steven Joseph Fadoir, PH.D.

  • Clinical Psychologist
  • Farmington Hills, MI
National Provider Identifier
1457486698
Registry record updated Aug 26, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
6301006008 Issued in MI
Practice address
31330 Northwestern Hwy
Suite D
Farmington Hills, MI 48334-2560
Phone
(248) 737-9903
NPI assigned
Feb 21, 2007
Last updated
Aug 26, 2016By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 26, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 6301006008 MI Primary

Addresses

Primary practice location

31330 Northwestern Hwy
Suite D
Farmington Hills, MI 48334-2560

Mailing address

31300 Northwestern Highway
Suite B
Farmington Hills, MI 48344
Phone (248) 737-9903

Other identifiers 2

IdentifierTypeStateIssuer
6301006008OtherMIPSYCHOLOGIST LICENSE-FULL
38-3553483OtherMIFEDERAL TAX ID

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
I20080820000697 MI Practitioner - Clinical Psychologist 4385719632 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

31300 Northwestern Hwy
Suite B
Farmington Hills, MI 48334-5407
Phone (248) 737-9903

31300 Northwestern Hwy B
Farmington Hills, MI 48334-5407

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
6301006008MIMDClinical Psychologist

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": "1172016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1472169600000",
    "number": "1457486698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31300 NORTHWESTERN HIGHWAY",
            "address_2": "SUITE B",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "48344",
            "telephone_number": "248-737-9903",
            "fax_number": "248-737-9963"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31330 NORTHWESTERN HWY",
            "address_2": "SUITE D",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483342560",
            "telephone_number": "248-737-9903"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FADOIR",
        "first_name": "STEVEN",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-21",
        "last_updated": "2016-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6301006008",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PSYCHOLOGIST LICENSE-FULL",
            "identifier": "6301006008",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FEDERAL TAX ID",
            "identifier": "38-3553483",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Farmington Hills, MI

Sources for this page

Verify at the official NPI Registry.