Active NPI
Deborah Ruddy Hansen, M.A.
- Clinical Psychologist
- Jackson, MI
National Provider Identifier
1457548737
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 6301006510
- Practice address
- 6 Universal Way
Jackson, MI 49202-1455 - Phone
- (517) 782-8714
- Fax
- (517) 782-8705
- NPI assigned
- Oct 1, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 6301006510 | MI | Primary |
Addresses
Primary practice location
6 Universal Way
Jackson, MI 49202-1455
Mailing address
6 Universal Way
Jackson, MI 49202-1455
Phone (517) 782-8714
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6301006510 | MI | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1191196800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1191196800000",
"number": "1457548737",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6 UNIVERSAL WAY",
"city": "JACKSON",
"state": "MI",
"postal_code": "492021455",
"telephone_number": "517-782-8714",
"fax_number": "517-782-8705"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6 UNIVERSAL WAY",
"city": "JACKSON",
"state": "MI",
"postal_code": "492021455",
"telephone_number": "517-782-8714",
"fax_number": "517-782-8705"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HANSEN",
"first_name": "DEBORAH",
"middle_name": "RUDDY",
"name_prefix": "Mrs.",
"credential": "M.A.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-10-01",
"last_updated": "2007-10-01",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "MI",
"license": "6301006510",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jackson, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.