Debra Ann Brodie, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

6301006340 Issued in MI

Practice address

300 River Place Dr Ste 5350-G
Detroit, MI 48207-4457

Phone

(313) 871-1450

Fax

(313) 468-1105

NPI assigned

Oct 16, 2005

Last updated

Sep 15, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

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

Specialty

Clinical Psychologist

Education

Other, 1984

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

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.

• D.a.Brodie,PH.D.P.C.

  • Clinical Psychologist
  • Detroit, MI
  • NPI 1710209010
  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1129420800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631664000000",
    "number": "1518956259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 RIVER PLACE DR STE 5350-G",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482074457",
            "telephone_number": "313-871-1450",
            "fax_number": "313-468-1105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 RIVER PLACE DR STE 5350-G",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482074457",
            "telephone_number": "313-871-1450",
            "fax_number": "313-468-1105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRODIE",
        "first_name": "DEBRA",
        "middle_name": "ANN",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-16",
        "last_updated": "2021-09-15",
        "certification_date": "2021-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MI",
            "license": "6301006340",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6301006340",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "38-3347895",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Madison Broadwell
• Delinda Brock
• Yaminah Brock
• Racquel Brockington, DO
• Brittany F Broda
• Victor Abadejos Brodith, DPT
• Casey Brodsky, MD, PHD
• Aaron Brody
• Joanne Stewart Brogdon, MSW
• Shireen A Brohi, M.D.

• Clinical Psychologist in Detroit, MI
• Providers in Detroit, MI by specialty
• Clinical Psychologist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2021; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.