Individual provider Active NPI

Robert David Handelsman, PH.D.

  • Clinical Psychologist
  • Bloomfield Hills, MI
National Provider Identifier
1619020591
Registry record updated Oct 6, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
6301001209 Issued in MI
Practice address
85 Judy LN
Bloomfield Hills, MI 48304-3934
Phone
(248) 647-7710
Fax
(248) 593-4717
NPI assigned
Jan 22, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 6, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 6301001209 MI Primary
Marriage & Family Therapist 106H00000X 4101005418 MI

Addresses

Primary practice location

85 Judy LN
Bloomfield Hills, MI 48304-3934

Mailing address

85 Judy LN
Bloomfield Hills, MI 48304-3934
Phone (248) 647-7710

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
I20040102000732 MI Practitioner - Clinical Psychologist 4880593425 Practice locations: Bloomfield Hills, MI

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1970
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

85 Judy LN
Bloomfield Hills, MI 48304-3934
Phone (248) 647-7710

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
6301001209MIMDClinical Psychologist
4101005418MIMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1169424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1317859200000",
    "number": "1619020591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "85 JUDY LN",
            "city": "BLOOMFIELD HILLS",
            "state": "MI",
            "postal_code": "483043934",
            "telephone_number": "248-647-7710",
            "fax_number": "248-593-4717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "85 JUDY LN",
            "city": "BLOOMFIELD HILLS",
            "state": "MI",
            "postal_code": "483043934",
            "telephone_number": "248-647-7710",
            "fax_number": "248-593-4717"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANDELSMAN",
        "first_name": "ROBERT",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-22",
        "last_updated": "2011-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6301001209",
            "primary": true
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MI",
            "license": "4101005418",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomfield Hills, MI

Sources for this page

Verify at the official NPI Registry.