Active NPI
Aaron Michael Reina, M.S., L.L.P.
- Psychologist
- Plymouth, MI
National Provider Identifier
1578816245
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 6361006597
- Practice address
- 1365 S Main St
Plymouth, MI 48170-2217 - Phone
- (734) 451-3440
- NPI assigned
- Oct 18, 2012
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 6301015331 | MI | |
| Clinical Psychologist | 103TC0700X | 6301015331 | MI | |
| Psychologist | 103T00000X | 6361006597 | MI | Primary |
Addresses
Primary practice location
1365 S Main St
Plymouth, MI 48170-2217
Mailing address
3410 Ridgeview Dr
Clyde, MI 48049-4318
Phone (313) 680-4614
Other practice location 1
2140 E Ellsworth Rd
Ann Arbor, MI 48108-2552
Phone (734) 971-2282
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
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6361006597 | MI | MD | Psychologist |
| 6301015331 | MI | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Henry Ford Health Eastwood Behavioral Health | Past | Accepting new patients |
Organizations & group practices 1
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.
-
dba Eastwood Clinics
- Social Worker
- Clinton Township, MI
- NPI 1396787701
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1350518400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1593993600000",
"number": "1578816245",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3410 RIDGEVIEW DR",
"city": "CLYDE",
"state": "MI",
"postal_code": "480494318",
"telephone_number": "313-680-4614"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1365 S MAIN ST",
"city": "PLYMOUTH",
"state": "MI",
"postal_code": "481702217",
"telephone_number": "734-451-3440"
}
],
"practiceLocations": [
{
"address_1": "2140 E Ellsworth Rd",
"address_purpose": "LOCATION",
"city": "Ann Arbor",
"state": "MI",
"postal_code": "481082552",
"country_code": "US",
"telephone_number": "734-971-2282",
"fax_number": "734-971-2487",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "REINA",
"first_name": "AARON",
"middle_name": "MICHAEL",
"name_prefix": "Mr.",
"credential": "M.S., L.L.P.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-10-18",
"last_updated": "2020-07-06",
"certification_date": "2020-07-06",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "MI",
"license": "6301015331",
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "MI",
"license": "6301015331",
"primary": false
},
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "MI",
"license": "6361006597",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Plymouth, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.