Individual provider Active NPI

Herman J. Daldin, PH.D.

  • Clinical Psychologist
  • Wyandotte, MI
National Provider Identifier
1588694376
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
6301005842 Issued in MI
Practice address
2514 Biddle St
Wyandotte, MI 48192-7891
Phone
(734) 246-4808
NPI assigned
Jul 4, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 6301005842 MI Primary

Addresses

Primary practice location

2514 Biddle St
Wyandotte, MI 48192-7891

Mailing address

22611 Lakecrest St
Saint Clair Shores, MI 48081-2486
Phone (586) 771-4041

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
I20080317000321 MI Practitioner - Clinical Psychologist 7517042443 Reassigns benefits to 1 organization
Practice locations: Wyandotte, MI

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

2514 Biddle Ave
Wyandotte, MI 48192-7891
Phone (734) 246-4808

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

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.

NPI Registry JSON

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

{
    "created_epoch": "1151971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1588694376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22611 LAKECREST ST",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "480812486",
            "telephone_number": "586-771-4041",
            "fax_number": "586-771-4041"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2514 BIDDLE ST",
            "city": "WYANDOTTE",
            "state": "MI",
            "postal_code": "481927891",
            "telephone_number": "734-246-4808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DALDIN",
        "first_name": "HERMAN",
        "middle_name": "J.",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6301005842",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wyandotte, MI

Sources for this page

Verify at the official NPI Registry.