Active NPI
Paula Jean Thomas, PH.D.
- Clinical Psychologist
- Southfield, MI
National Provider Identifier
1730233313
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 6301003342
- Practice address
- 17515 W 9 Mile Rd
Suite 975
Southfield, MI 48075-4403 - Phone
- (248) 557-3030
- Fax
- (248) 557-4214
- NPI assigned
- Jan 22, 2007
- 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 6
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Cognitive & Behavioral Psychologist | 103TB0200X | 6301003342 | MI | |
| Clinical Psychologist | 103TC0700X | 6301003342 | MI | Primary |
| Exercise & Sports Psychologist | 103TE1100X | 6301003342 | MI | |
| Health Service Psychologist | 103TH0100X | 6301003342 | MI | |
| Group Psychotherapy Psychologist | 103TP2701X | 6301003342 | MI | |
| Rehabilitation Psychologist | 103TR0400X | 6301003342 | MI |
Addresses
Primary practice location
17515 W 9 Mile Rd
Suite 975
Southfield, MI 48075-4403
Mailing address
17515 W 9 Mile Rd
Suite 975
Southfield, MI 48075-4403
Phone (248) 557-3030
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 037366 | Other | MI | VALUE OPTIONS PROVIDER ID |
| OF32385 | Other | MI | BCBS PROVIDER ID# |
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)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6301003342 | MI | MD | Health Service Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169424000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1197590400000",
"number": "1730233313",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17515 W 9 MILE RD",
"address_2": "SUITE 975",
"city": "SOUTHFIELD",
"state": "MI",
"postal_code": "480754403",
"telephone_number": "248-557-3030",
"fax_number": "248-557-4214"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17515 W 9 MILE RD",
"address_2": "SUITE 975",
"city": "SOUTHFIELD",
"state": "MI",
"postal_code": "480754403",
"telephone_number": "248-557-3030",
"fax_number": "248-557-4214"
}
],
"practiceLocations": [],
"basic": {
"last_name": "THOMAS",
"first_name": "PAULA",
"middle_name": "JEAN",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-01-22",
"last_updated": "2007-12-14",
"status": "A"
},
"taxonomies": [
{
"code": "103TB0200X",
"taxonomy_group": "",
"desc": "Psychologist, Cognitive & Behavioral",
"state": "MI",
"license": "6301003342",
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "MI",
"license": "6301003342",
"primary": true
},
{
"code": "103TE1100X",
"taxonomy_group": "",
"desc": "Psychologist, Exercise & Sports",
"state": "MI",
"license": "6301003342",
"primary": false
},
{
"code": "103TH0100X",
"taxonomy_group": "",
"desc": "Psychologist, Health Service",
"state": "MI",
"license": "6301003342",
"primary": false
},
{
"code": "103TP2701X",
"taxonomy_group": "",
"desc": "Psychologist, Group Psychotherapy",
"state": "MI",
"license": "6301003342",
"primary": false
},
{
"code": "103TR0400X",
"taxonomy_group": "",
"desc": "Psychologist, Rehabilitation",
"state": "MI",
"license": "6301003342",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "VALUE OPTIONS PROVIDER ID",
"identifier": "037366",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS PROVIDER ID#",
"identifier": "OF32385",
"state": "MI"
}
],
"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 Dec 14, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.