Connie Haley, PHD, LP

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

6301006010 Issued in MI

Practice address

5665 W Maple Rd
Ste. a
West Bloomfield, MI 48322-3741

Phone

(248) 538-1958

Fax

(248) 626-8836

NPI assigned

Jun 29, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 1994

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

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.

• Connie Haley, PC

  • Clinical Psychologist
  • West Bloomfield, MI
  • NPI 1710181946
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1151539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1720016645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5665 W MAPLE RD",
            "address_2": "STE. A",
            "city": "WEST BLOOMFIELD",
            "state": "MI",
            "postal_code": "483223741",
            "telephone_number": "248-538-1958",
            "fax_number": "248-626-8836"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5665 W MAPLE RD",
            "address_2": "STE. A",
            "city": "WEST BLOOMFIELD",
            "state": "MI",
            "postal_code": "483223741",
            "telephone_number": "248-538-1958",
            "fax_number": "248-626-8836"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALEY",
        "first_name": "CONNIE",
        "name_prefix": "Dr.",
        "credential": "PHD, LP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6301006010",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "680F301210",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ann Haitta, DDS
• Wael Hakmeh, D.O.
• Karmen Halabu, REGISTERED DIETITIAN
• Shakib Elias Halabu, DDS
• Joshua Steven Hales, MD
• Courtenay Monee' Hall, CRNA
• Hailee Hall
• Terry J Hall, LPN
• Vicki Hall, RN
• Kathleen Halvorson

• Clinical Psychologist in West Bloomfield, MI
• Providers in West Bloomfield, MI by specialty
• Clinical Psychologist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.