Individual provider Active NPI

Lilah Clevey

  • Clinical Psychologist
  • Ann Arbor, MI
National Provider Identifier
1528632536
Registry record updated May 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
6362002612 Issued in MI
Practice address
5340 Plymouth Rd Ste 202
Ann Arbor, MI 48105-9341
Phone
(734) 369-6084
NPI assigned
May 14, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 14, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 6362002612 MI Primary

Addresses

Primary practice location

5340 Plymouth Rd Ste 202
Ann Arbor, MI 48105-9341

Mailing address

410 Ferris St
Ypsilanti, MI 48197-5302
Phone (248) 231-1394

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
I20220928001228 MI Practitioner - Clinical Psychologist 3072916329 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Victor M. Cruz MD, P.C.Group PAC ID 3375604952, 29 clinicians

Practice addresses (Care Compare)

17177 N Laurel Park Dr
Suite 131
Livonia, MI 48152-3952
Phone (734) 462-3210

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6362002612MIMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Lilah Clevey PLLC Clinical Current Accepting new patients
Victor M. Cruz MD, P.C. CurrentSince Sep 7, 2022 Accepting new patients

Locations

5340 Plymouth Rd
Ste 202
Ann Arbor, MI 48105
Phone (734) 206-2888

17177 N Laurel Park Dr
Ste 131
Livonia, MI 48152
Phone (734) 462-3210

2202 Mitchell Park Dr
Ste 2B
Petoskey, MI 49770
Phone (231) 487-1750

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1620950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620950400000",
    "number": "1528632536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "410 FERRIS ST",
            "city": "YPSILANTI",
            "state": "MI",
            "postal_code": "481975302",
            "telephone_number": "248-231-1394"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5340 PLYMOUTH RD STE 202",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481059341",
            "telephone_number": "734-369-6084"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLEVEY",
        "first_name": "LILAH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-14",
        "last_updated": "2021-05-14",
        "certification_date": "2021-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6362002612",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ann Arbor, MI

Sources for this page

Verify at the official NPI Registry.