Active NPI
Stephen James Aquino, PSY.D.
- Clinical Psychologist
- Ann Arbor, MI
National Provider Identifier
1700177672
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 6301009827
- Practice address
- 2350 Washtenaw Ave Ste 7H
Ann Arbor, MI 48104-4532 - Phone
- (734) 358-3495
- NPI assigned
- Apr 27, 2011
- 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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 6301009827 | MI | Primary |
Addresses
Primary practice location
2350 Washtenaw Ave Ste 7H
Ann Arbor, MI 48104-4532
Mailing address
2350 Washtenaw Ave Ste 7H
Ann Arbor, MI 48104-4532
Phone (734) 358-3495
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20200323002999 | MI | Practitioner - Clinical Psychologist | 3971931098 | Practice locations: Ann Arbor, MI |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6301009827 | MI | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1303862400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1303862400000",
"number": "1700177672",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2350 WASHTENAW AVE STE 7H",
"city": "ANN ARBOR",
"state": "MI",
"postal_code": "481044532",
"telephone_number": "734-358-3495"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2350 WASHTENAW AVE STE 7H",
"city": "ANN ARBOR",
"state": "MI",
"postal_code": "481044532",
"telephone_number": "734-358-3495"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AQUINO",
"first_name": "STEPHEN",
"middle_name": "JAMES",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-04-27",
"last_updated": "2011-04-27",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "MI",
"license": "6301009827",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ann Arbor, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.