Abaris Behavioral Health

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

6301012845 Issued in MI

Legal business name

ABARIS BEHAVIORAL HEALTH

Practice address

5010 S Nocturne LN
Shelby Township, MI 48316-5232

Phone

(586) 747-0206

NPI assigned

Jun 7, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Paul Lucki Smith, PHDNPI 1376533265

Title

President

Phone

(586) 747-0206

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Paul Lucki Smith, PH.D.

  • Clinical Psychologist
  • Armada, MI
  • NPI 1376533265
  Authorized official Same address or phone

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

{
    "created_epoch": "1181174400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1801099965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5010 S NOCTURNE LN",
            "city": "SHELBY TOWNSHIP",
            "state": "MI",
            "postal_code": "483165232",
            "telephone_number": "586-747-0206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5010 S NOCTURNE LN",
            "city": "SHELBY TOWNSHIP",
            "state": "MI",
            "postal_code": "483165232",
            "telephone_number": "586-747-0206"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ABARIS BEHAVIORAL HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-07",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "LUCKI",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "586-747-0206",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6301012845",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Psychologist in Shelby Township, MI
• Providers in Shelby Township, MI by specialty
• Clinical Psychologist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.