Active NPI
Freeman Shields, LLP
- Clinical Psychologist
- Dearborn, MI
National Provider Identifier
1629629944
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 6361007754
- Practice address
- 5728 Schaefer Rd
Dearborn, MI 48126-2298 - Phone
- (313) 354-6234
- NPI assigned
- Sep 27, 2019
- 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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 6361007754 | MI | Primary |
Addresses
Primary practice location
5728 Schaefer Rd
Dearborn, MI 48126-2298
Mailing address
28470 Eastbrook CT
Farmington Hills, MI 48334-4253
Phone (248) 840-3087
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6361007754 | MI | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1569542400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1669593600000",
"number": "1629629944",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "28470 EASTBROOK CT",
"city": "FARMINGTON HILLS",
"state": "MI",
"postal_code": "483344253",
"telephone_number": "248-840-3087"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5728 SCHAEFER RD",
"city": "DEARBORN",
"state": "MI",
"postal_code": "481262298",
"telephone_number": "313-354-6234"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHIELDS",
"first_name": "FREEMAN",
"name_prefix": "Mr.",
"credential": "LLP",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-09-27",
"last_updated": "2022-11-28",
"certification_date": "2022-11-18",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "MI",
"license": "6361007754",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dearborn, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 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.