Active NPI
Beth Wyrybkowski, MA, TLLP
- Psychologist
- Rochester Hills, MI
National Provider Identifier
1508424557
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 6301016572
- Practice address
- 245 Barclay Cir Ste 400
Rochester Hills, MI 48307-5812 - Phone
- (248) 217-8700
- NPI assigned
- Jun 4, 2019
- Sex
- Female
- Sole proprietor
- Yes
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 | 6301016572 | MI | Primary |
Addresses
Primary practice location
245 Barclay Cir Ste 400
Rochester Hills, MI 48307-5812
Mailing address
29621 Sherry Ave
Madison Heights, MI 48071-4429
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 |
|---|---|---|---|
| 6301016572 | MI | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1559606400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1559606400000",
"number": "1508424557",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "29621 SHERRY AVE",
"city": "MADISON HEIGHTS",
"state": "MI",
"postal_code": "480714429"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "245 BARCLAY CIR STE 400",
"city": "ROCHESTER HILLS",
"state": "MI",
"postal_code": "483075812",
"telephone_number": "248-217-8700"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WYRYBKOWSKI",
"first_name": "BETH",
"name_prefix": "Miss",
"credential": "MA, TLLP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-06-04",
"last_updated": "2019-06-04",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Psychologist",
"state": "MI",
"license": "6301016572",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rochester Hills, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.