Active NPI
Cassidy B Slade, PSYD
- Psychologist
- Southfield, MI
National Provider Identifier
1700652310
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 6301019407
- Practice address
- 29500 Southfield Rd
Southfield, MI 48076-2030 - Phone
- (248) 765-1795
- NPI assigned
- Nov 27, 2023
- Last updated
- Nov 27, 2023
- Sex
- Female
- Sole proprietor
- No
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 | 6301019407 | MI | Primary |
Addresses
Primary practice location
29500 Southfield Rd
Southfield, MI 48076-2030
Mailing address
10399 Lakeshore Dr E
Goodrich, MI 48438-8705
Phone (248) 459-2411
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6301019407 | MI | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1701043200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1701043200000",
"number": "1700652310",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10399 LAKESHORE DR E",
"city": "GOODRICH",
"state": "MI",
"postal_code": "484388705",
"telephone_number": "248-459-2411"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "29500 SOUTHFIELD RD",
"city": "SOUTHFIELD",
"state": "MI",
"postal_code": "480762030",
"telephone_number": "248-765-1795"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SLADE",
"first_name": "CASSIDY",
"middle_name": "B",
"name_prefix": "Dr.",
"credential": "PSYD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-11-27",
"last_updated": "2023-11-27",
"certification_date": "2023-11-27",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "MI",
"license": "6301019407",
"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 Nov 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.