Individual provider Active NPI

Michael Edward Behen, PHD

  • Clinical Psychologist
  • Livonia, MI
National Provider Identifier
1760407696
Registry record updated Jul 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
63010013057 Issued in MI
Practice address
37625 Pembroke Ave
Livonia, MI 48152-1050
Phone
(313) 656-4052
NPI assigned
Jul 13, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 10, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Cognitive & Behavioral Psychologist 103TB0200X 6301013057 MI
Clinical Child & Adolescent Psychologist 103TC2200X 6301013057 MI
Intellectual & Developmental Disabilities Psychologist 103TM1800X 6301013057 MI
Clinical Psychologist 103TC0700X 63010013057 MI Primary

Addresses

Primary practice location

37625 Pembroke Ave
Livonia, MI 48152-1050

Mailing address

2620 Woodward Ave
Detroit, MI 48201-3029
Phone (313) 354-3920

Other practice location 1

37625 Pembroke Ave
Livonia, MI 48152-1050
Phone (313) 656-4052

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20090120000125 MI Practitioner - Clinical Psychologist 5496845554 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

37625 Pembroke Ave
Livonia, MI 48152-1050
Phone (313) 656-4052

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
63010013057MIMDClinical Psychologist
6301013057MIMDIntellectual & Developmental Disabilities Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Imagine Transporation LLC CurrentSince Jul 13, 2025 Accepting new patients
Imagine Center LLC Clinical CurrentSince Nov 26, 2015 Accepting new patients

Locations

4160 Woodward Ave
Fl 2
Detroit, MI 48201
Phone (313) 264-3781

37625 Pembroke Ave
Livonia, MI 48152
Phone (734) 201-0343

194 E Main St
Northville, MI 48167
Phone (248) 719-7671

42140 Van Dyke Ave
Ste 190
Sterling Heights, MI 48314

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1152748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752105600000",
    "number": "1760407696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2620 WOODWARD AVE",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482013029",
            "telephone_number": "313-354-3920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "37625 PEMBROKE AVE",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481521050",
            "telephone_number": "313-656-4052"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "37625 Pembroke Ave",
            "address_purpose": "LOCATION",
            "city": "Livonia",
            "state": "MI",
            "postal_code": "481521050",
            "country_code": "US",
            "telephone_number": "313-656-4052",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BEHEN",
        "first_name": "MICHAEL",
        "middle_name": "EDWARD",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-13",
        "last_updated": "2025-07-10",
        "certification_date": "2025-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": "MI",
            "license": "6301013057",
            "primary": false
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "MI",
            "license": "6301013057",
            "primary": false
        },
        {
            "code": "103TM1800X",
            "taxonomy_group": "",
            "desc": "Psychologist, Intellectual & Developmental Disabilities",
            "state": "MI",
            "license": "6301013057",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "63010013057",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Livonia, MI

Sources for this page

Verify at the official NPI Registry.