Active NPI
Cassandra Marie Thomas
- Clinical Psychologist
- Southfield, MI
National Provider Identifier
1710652748
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 6362009361
- Practice address
- 29548 Southfield Rd Ste 100
Southfield, MI 48076-2028 - Phone
- (313) 603-5823
- NPI assigned
- Aug 11, 2021
- Sex
- Female
- 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 | 6362009361 | MI | Primary |
Addresses
Primary practice location
29548 Southfield Rd Ste 100
Southfield, MI 48076-2028
Mailing address
187 W Wilson Ave
Pontiac, MI 48341-2863
Phone (248) 707-4339
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 |
|---|---|---|---|
| 6362009361 | MI | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1628640000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1628640000000",
"number": "1710652748",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "187 W WILSON AVE",
"city": "PONTIAC",
"state": "MI",
"postal_code": "483412863",
"telephone_number": "248-707-4339",
"fax_number": "248-499-7081"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "29548 SOUTHFIELD RD STE 100",
"city": "SOUTHFIELD",
"state": "MI",
"postal_code": "480762028",
"telephone_number": "313-603-5823"
}
],
"practiceLocations": [],
"basic": {
"last_name": "THOMAS",
"first_name": "CASSANDRA",
"middle_name": "MARIE",
"name_prefix": "Mrs.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-08-11",
"last_updated": "2021-08-11",
"certification_date": "2021-08-11",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "MI",
"license": "6362009361",
"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 Aug 11, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.