Mark Rene Desroberts, M.A.,L.L.P.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

L1182507 Issued in MI

Practice address

159 Kercheval Ave
Grosse Pointe Farms, MI 48236-3610

Phone

(313) 640-2217

NPI assigned

Nov 5, 2008

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

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

{
    "created_epoch": "1225843200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1225843200000",
    "number": "1548414410",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5425 COPLEY SQUARE RD",
            "city": "GRAND BLANC",
            "state": "MI",
            "postal_code": "484398743",
            "telephone_number": "810-694-1008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "159 KERCHEVAL AVE",
            "city": "GROSSE POINTE FARMS",
            "state": "MI",
            "postal_code": "482363610",
            "telephone_number": "313-640-2217"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DESROBERTS",
        "first_name": "MARK",
        "middle_name": "RENE",
        "name_prefix": "Mr.",
        "credential": "M.A.,L.L.P.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-11-05",
        "last_updated": "2008-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "L1182507",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dan G Guyer, M.D., P.C.
• Amanda Diane Dawnrich, RSST
• Dana Deimel, M.A.,CCC-SLP
• Anthony Francis Deluca
• Milton James Desgrandchamp, CRNA
• Diane S Smith PC
• Heather Annatoyn Dickson, MD
• Robert R Diloreto, M.D.
• Michael James Dionne, M.D.
• Jonathan Doellner

• Clinical Psychologist in Grosse Pointe Farms, MI
• Providers in Grosse Pointe Farms, MI by specialty
• Clinical Psychologist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.