Active NPI
Matthew David Ensing, MA, LLP
- Psychologist
- Traverse City, MI
National Provider Identifier
1609270347
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 6361001715
- Practice address
- 1050 Silver Dr
Traverse City, MI 49684-5749 - Phone
- (231) 947-2255
- NPI assigned
- Oct 9, 2014
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 6361001715 | MI | Primary |
Addresses
Primary practice location
1050 Silver Dr
Traverse City, MI 49684-5749
Mailing address
2140 Stanley Creek Dr
Interlochen, MI 49643-9351
Phone (989) 302-0969
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 Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6361001715 | MI | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1412812800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1646092800000",
"number": "1609270347",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2140 STANLEY CREEK DR",
"city": "INTERLOCHEN",
"state": "MI",
"postal_code": "496439351",
"telephone_number": "989-302-0969"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1050 SILVER DR",
"city": "TRAVERSE CITY",
"state": "MI",
"postal_code": "496845749",
"telephone_number": "231-947-2255"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ENSING",
"first_name": "MATTHEW",
"middle_name": "DAVID",
"credential": "MA, LLP",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-10-09",
"last_updated": "2022-03-01",
"certification_date": "2022-03-01",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "MI",
"license": "6361001715",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Traverse City, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.