Individual provider Active NPI

Emily Jane Escott, PSYD

  • Clinical Psychologist
  • Pleasant Ridge, MI
National Provider Identifier
1518274331
Registry record updated Oct 27, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
6301016394 Issued in MI
Practice address
23650 Woodward Ave
Pleasant Ridge, MI 48069-1128
Phone
(248) 346-1200
NPI assigned
Sep 1, 2010
Last updated
Oct 27, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2016

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 6301016394 MI Primary
Clinical Child & Adolescent Psychologist 103TC2200X 6301016394 MI
Health Service Psychologist 103TH0100X 6301016394 MI
Health Psychologist 103TH0004X 6301016394 MI
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

23650 Woodward Ave
Pleasant Ridge, MI 48069-1128

Mailing address

2331 Hamata St
Ferndale, MI 48220-1549
Phone (248) 909-2023

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
I20170130000520 MI Practitioner - Clinical Psychologist 7214219179 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Essential Neuropsychology Consultants LLCGroup PAC ID 9032653159, 2 clinicians

Practice addresses (Care Compare)

25600 Woodward Ave
Suite 109
Royal Oak, MI 48067-0944
Phone (248) 909-2023

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6301016394MIMDHealth Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Jawad a Shah MD PC CurrentSince May 1, 2017 Accepting new patients
Essential Neuropsychology Consultants LLC Psychologist CurrentSince May 23, 2024 Accepting new patients
Jawad a Shah, MD PC CurrentSince May 1, 2017 Accepting new patients

Locations

4800 S Saginaw St
Ste 1800
Flint, MI 48507
Phone (810) 732-8336

4800 S Saginaw St
Ste 1805
Flint, MI 48507
Phone (810) 275-9108

4800 S Saginaw St
Ste 1815
Flint, MI 48507
Phone (810) 275-9152

25600 Woodward Ave
Ste 109
Royal Oak, MI 48067
Phone (248) 429-9145

Organizations & group practices 3

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": "1283299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1477526400000",
    "number": "1518274331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2331 HAMATA ST",
            "city": "FERNDALE",
            "state": "MI",
            "postal_code": "482201549",
            "telephone_number": "248-909-2023",
            "fax_number": "313-656-4053"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23650 WOODWARD AVE",
            "city": "PLEASANT RIDGE",
            "state": "MI",
            "postal_code": "480691128",
            "telephone_number": "248-346-1200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ESCOTT",
        "first_name": "EMILY",
        "middle_name": "JANE",
        "name_prefix": "Ms.",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-09-01",
        "last_updated": "2016-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6301016394",
            "primary": true
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "MI",
            "license": "6301016394",
            "primary": false
        },
        {
            "code": "103TH0100X",
            "taxonomy_group": "",
            "desc": "Psychologist, Health Service",
            "state": "MI",
            "license": "6301016394",
            "primary": false
        },
        {
            "code": "103TH0004X",
            "taxonomy_group": "",
            "desc": "Psychologist, Health",
            "state": "MI",
            "license": "6301016394",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pleasant Ridge, MI

Sources for this page

Verify at the official NPI Registry.