Active NPI
Loretta Polish, PHD PSYCHOLOGIST
- Psychologist
- Southfield, MI
National Provider Identifier
1487755609
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 6301007306
- Practice address
- 29260 Franklin Rd
Suite 129
Southfield, MI 48034 - Phone
- (248) 352-6445
- Fax
- (248) 357-0102
- NPI assigned
- Sep 26, 2006
- 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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | 6301007306 | MI | Primary |
Addresses
Primary practice location
29260 Franklin Rd
Suite 129
Southfield, MI 48034
Mailing address
29260 Franklin Rd
Suite 129
Southfield, MI 48034
Phone (248) 352-6445
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159228800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1487755609",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "29260 FRANKLIN RD",
"address_2": "SUITE 129",
"city": "SOUTHFIELD",
"state": "MI",
"postal_code": "48034",
"telephone_number": "248-352-6445",
"fax_number": "248-357-0102"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "29260 FRANKLIN RD",
"address_2": "SUITE 129",
"city": "SOUTHFIELD",
"state": "MI",
"postal_code": "48034",
"telephone_number": "248-352-6445",
"fax_number": "248-357-0102"
}
],
"practiceLocations": [],
"basic": {
"last_name": "POLISH",
"first_name": "LORETTA",
"credential": "PHD PSYCHOLOGIST",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-09-26",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "MI",
"license": "6301007306",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Southfield, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.