Active NPI
Rene Roberts
- Psychologist
- Northville, MI
National Provider Identifier
1780185074
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 6301015920
- Practice address
- 42000 6 Mile Rd Ste 202
Northville, MI 48168-4374 - Phone
- (248) 283-3703
- NPI assigned
- Feb 22, 2018
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 6301015920 | MI | |
| Psychologist | 103T00000X | 6301015920 | MI | Primary |
Addresses
Primary practice location
42000 6 Mile Rd Ste 202
Northville, MI 48168-4374
Mailing address
42000 6 Mile Rd Ste 202
Northville, MI 48168-4374
Phone (248) 283-3703
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6301015920 | MI | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Thriving Lives Inc. | Psychologist | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Psychologist
- Northville, MI
- NPI 1356852552
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1519257600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1519257600000",
"number": "1780185074",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "42000 6 MILE RD STE 202",
"city": "NORTHVILLE",
"state": "MI",
"postal_code": "481684374",
"telephone_number": "248-283-3703"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "42000 6 MILE RD STE 202",
"city": "NORTHVILLE",
"state": "MI",
"postal_code": "481684374",
"telephone_number": "248-283-3703"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROBERTS",
"first_name": "RENE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-02-22",
"last_updated": "2018-02-22",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "MI",
"license": "6301015920",
"primary": false
},
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "MI",
"license": "6301015920",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Northville, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 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.