Active NPI
Michael Gassen, PSY.D.
- Clinical Psychologist
- Laurens, SC
National Provider Identifier
1619166246
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 1109
- Practice address
- 100 Hillcrest SQ Ste J
Laurens, SC 29360-2355 - Phone
- (864) 984-2518
- NPI assigned
- Oct 19, 2007
- Sex
- Male
- Sole proprietor
- No
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1109 | SC | MD | Physician Assistant |
Specialties & licenses 1
NPPES NPI Registry| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 1109 | SC | Primary |
Addresses
NPPES NPI RegistryPrimary practice location
100 Hillcrest SQ Ste J
Laurens, SC 29360-2355
Mailing address
100 Hillcrest SQ Ste J
Laurens, SC 29360-2355
Phone (864) 984-2518
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Dec 29, 2017.
{
"created_epoch": "1192752000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1514505600000",
"number": "1619166246",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "100 HILLCREST SQ STE J",
"city": "LAURENS",
"state": "SC",
"postal_code": "293602355",
"telephone_number": "864-984-2518"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 HILLCREST SQ STE J",
"city": "LAURENS",
"state": "SC",
"postal_code": "293602355",
"telephone_number": "864-984-2518"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GASSEN",
"first_name": "MICHAEL",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-10-19",
"last_updated": "2017-12-29",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "SC",
"license": "1109",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Laurens, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.