Individual provider Active NPI

Renee Bouey, PH.D.

  • School Psychologist
  • Detroit, MI
National Provider Identifier
1629475199
Registry record updated Nov 29, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
School PsychologistTaxonomy code 103TS0200X
License
CC-0C1790525433 Issued in MI
Practice address
18480 Lancashire St
Detroit, MI 48223-1325
Phone
(313) 272-0250
NPI assigned
Nov 29, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 29, 2014

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 6301002743 MI
School Psychologist 103TS0200X CC-0C1790525433 MI Primary

Addresses

Primary practice location

18480 Lancashire St
Detroit, MI 48223-1325

Mailing address

18480 Lancashire St
Detroit, MI 48223-1325

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
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
6301002743MIMDClinical Psychologist
CC-0C1790525433MIMDSchool Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1417219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1417219200000",
    "number": "1629475199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18480 LANCASHIRE ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482231325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18480 LANCASHIRE ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482231325",
            "telephone_number": "313-272-0250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOUEY",
        "first_name": "RENEE",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-11-29",
        "last_updated": "2014-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6301002743",
            "primary": false
        },
        {
            "code": "103TS0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, School",
            "state": "MI",
            "license": "CC-0C1790525433",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.