Victor Ip

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

6362010047 Issued in MI

Practice address

7375 Woodward Ave Ste 2800
Detroit, MI 48202-3157

Phone

(313) 710-8744

Fax

(855) 568-2494

NPI assigned

Jun 11, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Behavior Frontiers, LLC

  • Behavior Analyst
  • Gardena, CA
  • NPI 1245539394
  NPD (past)

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

{
    "created_epoch": "1560211200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736985600000",
    "number": "1629637962",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7375 WOODWARD AVE STE 2800",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482023157",
            "telephone_number": "313-710-8744",
            "fax_number": "855-568-2494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7375 WOODWARD AVE STE 2800",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482023157",
            "telephone_number": "313-710-8744",
            "fax_number": "855-568-2494"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IP",
        "first_name": "VICTOR",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-06-11",
        "last_updated": "2025-01-16",
        "certification_date": "2025-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6362010047",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• International Medical Supply Company
• John S Inthavongsa, DNP RN AGACNP-BC
• Alyssa Monette Sotto Intig
• Emily M Ioco, PA-C
• Rachel Iovan
• Aramide Abiola Iposu
• Amir Iqbal, M.D.
• Asra Iqbal, MD
• Nireman Iqbal, MD
• Sana Iqbal, M.D

• Clinical Psychologist in Detroit, MI
• Providers in Detroit, MI by specialty
• Clinical Psychologist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2025; 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.