Active NPI
Sam Cherian, PH.D.
- Psychologist
- Southfield, MI
National Provider Identifier
1700054814
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 6301011838
- Practice address
- 17105 W 12 Mile Rd
Southfield, MI 48076-2104 - Phone
- (248) 557-8390
- Fax
- (248) 557-6427
- NPI assigned
- Feb 12, 2008
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | 6301011838 | MI | Primary |
Addresses
Primary practice location
17105 W 12 Mile Rd
Southfield, MI 48076-2104
Mailing address
17105 W 12 Mile Rd
Southfield, MI 48076-2104
Phone (248) 557-8390
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
| License | State | Type | Specialty |
|---|---|---|---|
| 6301011838 | MI | MD | Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Christian Family Services-Pyo Inc | Past | Accepting new patients |
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 and National Provider Directory roles.
-
- Community/Behavioral Health Agency
- Southfield, MI
- NPI 1396153698
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1202774400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1202774400000",
"number": "1700054814",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17105 W 12 MILE RD",
"city": "SOUTHFIELD",
"state": "MI",
"postal_code": "480762104",
"telephone_number": "248-557-8390",
"fax_number": "248-557-6427"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17105 W 12 MILE RD",
"city": "SOUTHFIELD",
"state": "MI",
"postal_code": "480762104",
"telephone_number": "248-557-8390",
"fax_number": "248-557-6427"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHERIAN",
"first_name": "SAM",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-02-12",
"last_updated": "2008-02-12",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "MI",
"license": "6301011838",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Southfield, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.