Active NPI
Jeff Joseph Archambault, MA LLP
- Psychologist
- Southfield, MI
National Provider Identifier
1720575889
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 6301008628
- Practice address
- 29895 Greenfield Rd
Southfield, MI 48076-5867 - Phone
- (248) 672-0143
- NPI assigned
- Apr 15, 2018
- 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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | 6301008628 | MI | Primary |
Addresses
Primary practice location
29895 Greenfield Rd
Southfield, MI 48076-5867
Mailing address
1206 Janlain CT
Bloomfield Hills, MI 48302-2804
Phone (248) 672-0143
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
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6301008628 | MI | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1523750400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1523750400000",
"number": "1720575889",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1206 JANLAIN CT",
"city": "BLOOMFIELD HILLS",
"state": "MI",
"postal_code": "483022804",
"telephone_number": "248-672-0143"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "29895 GREENFIELD RD",
"city": "SOUTHFIELD",
"state": "MI",
"postal_code": "480765867",
"telephone_number": "248-672-0143"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ARCHAMBAULT",
"first_name": "JEFF",
"middle_name": "JOSEPH",
"name_prefix": "Mr.",
"credential": "MA LLP",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2018-04-15",
"last_updated": "2018-04-15",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "MI",
"license": "6301008628",
"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 Apr 15, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.