Individual provider Active NPI

Evelyn Foreman

  • Clinical Psychologist
  • Livonia, MI
National Provider Identifier
1790177798
Registry record updated Feb 27, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
6301007798 Issued in MI
Practice address
33505 Schoolcraft Rd
Suite 3
Livonia, MI 48150-1630
Phone
(734) 721-0200
NPI assigned
Feb 27, 2015
Last updated
Feb 27, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 6301007798 MI Primary

Addresses

Primary practice location

33505 Schoolcraft Rd
Suite 3
Livonia, MI 48150-1630

Mailing address

17344 Oak Dr
FL2
Detroit, MI 48221-3724
Phone (313) 861-9490

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

State licenses

LicenseStateTypeSpecialty
6301007798MIMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Hegira Health, Inc. Past Accepting new patients
Carol a. Roekle, M.D., P.C. Past Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1424995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1424995200000",
    "number": "1790177798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17344 OAK DR",
            "address_2": "FL2",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482213724",
            "telephone_number": "313-861-9490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33505 SCHOOLCRAFT RD",
            "address_2": "SUITE 3",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481501630",
            "telephone_number": "734-721-0200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOREMAN",
        "first_name": "EVELYN",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-02-27",
        "last_updated": "2015-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6301007798",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Livonia, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2015; 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.