Active NPI
Daniel Eli Greenberg, PH.D.
- Clinical Psychologist
- Ann Arbor, MI
National Provider Identifier
1629299961
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 6301007903
- Practice address
- 2311 E Stadium Blvd Ste 105S
Ann Arbor, MI 48104-4821 - Phone
- (734) 741-0484
- NPI assigned
- May 2, 2007
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 6301007903 | MI | Primary |
Addresses
Primary practice location
2311 E Stadium Blvd Ste 105S
Ann Arbor, MI 48104-4821
Mailing address
2311 E Stadium Blvd Ste 105S
Ann Arbor, MI 48104-4821
Phone (734) 741-0484
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 680H147950 | Other | MI | BCBS PIN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
- Opted out of Medicare
- Yes, effective Jan 1, 2018 through Jan 1, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6301007903 | MI | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1178064000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1617494400000",
"number": "1629299961",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2311 E STADIUM BLVD STE 105S",
"city": "ANN ARBOR",
"state": "MI",
"postal_code": "481044821",
"telephone_number": "734-741-0484"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2311 E STADIUM BLVD STE 105S",
"city": "ANN ARBOR",
"state": "MI",
"postal_code": "481044821",
"telephone_number": "734-741-0484"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GREENBERG",
"first_name": "DANIEL",
"middle_name": "ELI",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-05-02",
"last_updated": "2021-04-04",
"certification_date": "2021-04-04",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "MI",
"license": "6301007903",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS PIN",
"identifier": "680H147950",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Ann Arbor, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.