Individual provider Active NPI

Michelle Renae Byrd, PH.D., LP

  • Psychologist
  • Plymouth, MI
National Provider Identifier
1720324908
Registry record updated Dec 17, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
6301012767 Issued in MI
Practice address
409 Plymouth Rd
Suite 250
Plymouth, MI 48170-1497
Phone
(734) 416-9098
NPI assigned
Dec 17, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 6301012767 MI Primary

Addresses

Primary practice location

409 Plymouth Rd
Suite 250
Plymouth, MI 48170-1497

Mailing address

409 Plymouth Rd
Suite 250
Plymouth, MI 48170-1497
Phone (734) 416-9098

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

LicenseStateTypeSpecialty
6301012767MIMDPsychologist

NPI Registry JSON

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

{
    "created_epoch": "1355702400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1355702400000",
    "number": "1720324908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "409 PLYMOUTH RD",
            "address_2": "SUITE 250",
            "city": "PLYMOUTH",
            "state": "MI",
            "postal_code": "481701497",
            "telephone_number": "734-416-9098"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "409 PLYMOUTH RD",
            "address_2": "SUITE 250",
            "city": "PLYMOUTH",
            "state": "MI",
            "postal_code": "481701497",
            "telephone_number": "734-416-9098"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BYRD",
        "first_name": "MICHELLE",
        "middle_name": "RENAE",
        "name_prefix": "Dr.",
        "credential": "PH.D., LP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-12-17",
        "last_updated": "2012-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MI",
            "license": "6301012767",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plymouth, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.