Individual provider Active NPI

Michael Brandon Purdum, PH.D

  • Clinical Psychologist
  • Cleveland, OH
National Provider Identifier
1659649747
Registry record updated Apr 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
6871 Issued in OH
Practice address
10701 East Blvd
Psychology Service 116B(W)
Cleveland, OH 44106-1702
Phone
(216) 791-3800
NPI assigned
Dec 5, 2011
Last updated
Apr 20, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 6871 OH Primary

Addresses

Primary practice location

10701 East Blvd
Psychology Service 116B(W)
Cleveland, OH 44106-1702

Mailing address

10701 East Blvd
Psychology Service 116B(W)
Cleveland, OH 44106-1702
Phone (216) 791-3800

Other practice location 1

9826 Washington St
Chagrin Falls, OH 44023-5401
Phone (440) 708-0188

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201123002535 OH Practitioner - Clinical Psychologist 4385055359 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
6871OHMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Jones-Wood Psychological Associates, Inc. CurrentSince Jan 1, 2021 Accepting new patients

Locations

9826 Washington St
Chagrin Falls, OH 44023
Phone (440) 708-0188

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1323043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776643200000",
    "number": "1659649747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10701 EAST BLVD",
            "address_2": "PSYCHOLOGY SERVICE 116B(W)",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441061702",
            "telephone_number": "216-791-3800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10701 EAST BLVD",
            "address_2": "PSYCHOLOGY SERVICE 116B(W)",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441061702",
            "telephone_number": "216-791-3800"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9826 Washington St",
            "address_purpose": "LOCATION",
            "city": "Chagrin Falls",
            "state": "OH",
            "postal_code": "440235401",
            "country_code": "US",
            "telephone_number": "440-708-0188",
            "fax_number": "440-708-0368",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PURDUM",
        "first_name": "MICHAEL",
        "middle_name": "BRANDON",
        "name_prefix": "Dr.",
        "credential": "PH.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-12-05",
        "last_updated": "2026-04-20",
        "certification_date": "2026-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "OH",
            "license": "6871",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, OH

Sources for this page

Verify at the official NPI Registry.