NPIMap

Organization Active NPI

Parker Clinic PLLC

  • Clinical Psychologist
  • Bloomfield Hills, MI
National Provider Identifier
1689100729
Registry record updated May 11, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
6301011448 Issued in MI
Legal business name
PARKER CLINIC PLLC
Practice address
43902 Woodward Ave Ste 110
Bloomfield Hills, MI 48302-5021
Phone
(248) 338-1700
NPI assigned
May 11, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 11, 2017

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

Authorized official

Name
Mitchell S Parker, LPNPI 1023167517
Title
Owner
Phone
(248) 338-1700

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC0700X 6301011448 MI Primary

Addresses

Primary practice location

43902 Woodward Ave Ste 110
Bloomfield Hills, MI 48302-5021

Mailing address

43902 Woodward Ave Ste 110
Bloomfield Hills, MI 48302-5021
Phone (248) 338-1700

National Provider Directory

National Provider Directory

Locations

43902 Woodward Ave
Ste 110
Bloomfield Hills, MI 48302
Phone (248) 338-1700

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1494460800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1494460800000",
    "number": "1689100729",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "43902 WOODWARD AVE STE 110",
            "city": "BLOOMFIELD HILLS",
            "state": "MI",
            "postal_code": "483025021",
            "telephone_number": "248-338-1700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "43902 WOODWARD AVE STE 110",
            "city": "BLOOMFIELD HILLS",
            "state": "MI",
            "postal_code": "483025021",
            "telephone_number": "248-338-1700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARKER CLINIC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-05-11",
        "last_updated": "2017-05-11",
        "status": "A",
        "authorized_official_last_name": "PARKER",
        "authorized_official_first_name": "MITCHELL",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "248-338-1700",
        "authorized_official_credential": "LP"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6301011448",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomfield Hills, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2017; 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.