Active NPI
Nicole Gegas, PH.D
- Clinical Psychologist
- Ann Arbor, MI
National Provider Identifier
1558778878
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 6301019738
- Practice address
- 3005 Boardwalk St Ste 201
Ann Arbor, MI 48108-5218 - Phone
- (734) 222-9277
- NPI assigned
- Jul 18, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 5
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 6301019738 | MI | Primary |
| Case Manager/Care Coordinator | 171M00000X | |||
| Psychologist | 103T00000X | 6301019738 | MI | |
| Psychologist | 103T00000X | 6351004729 | MI | |
| Student in an Organized Health Care Education/Training Program | 390200000X |
Addresses
Primary practice location
3005 Boardwalk St Ste 201
Ann Arbor, MI 48108-5218
Mailing address
3005 Boardwalk St Ste 201
Ann Arbor, MI 48108-5218
Phone (734) 222-9277
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1473276 | Medicaid | OH |
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
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6301019738 | MI | MD | Psychologist |
| 6351004729 | MI | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1405641600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1765324800000",
"number": "1558778878",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3005 BOARDWALK ST STE 201",
"city": "ANN ARBOR",
"state": "MI",
"postal_code": "481085218",
"telephone_number": "734-222-9277",
"fax_number": "888-972-3797"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3005 BOARDWALK ST STE 201",
"city": "ANN ARBOR",
"state": "MI",
"postal_code": "481085218",
"telephone_number": "734-222-9277"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GEGAS",
"first_name": "NICOLE",
"credential": "PH.D",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-07-18",
"last_updated": "2025-12-10",
"certification_date": "2025-12-10",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "MI",
"license": "6301019738",
"primary": true
},
{
"code": "171M00000X",
"taxonomy_group": "",
"desc": "Case Manager/Care Coordinator",
"state": null,
"license": null,
"primary": false
},
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "MI",
"license": "6301019738",
"primary": false
},
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "MI",
"license": "6351004729",
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1473276",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Ann Arbor, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.