Active NPI
Thomas Micheal Shaker, M.S. L.L.P.
- Clinical Psychologist
- Wayne, MI
National Provider Identifier
1811185846
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 6301008157
- Practice address
- 35425 W Michigan Ave
Wayne, MI 48184-1687 - Phone
- (734) 729-7792
- NPI assigned
- Oct 3, 2007
- Last updated
- Oct 3, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 6301008157 | MI | Primary |
Addresses
Primary practice location
35425 W Michigan Ave
Wayne, MI 48184-1687
Mailing address
580 Chester St
South Lyon, MI 48178-1125
Phone (248) 486-4228
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6301008157 | MI | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1191369600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1191369600000",
"number": "1811185846",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "580 CHESTER ST",
"city": "SOUTH LYON",
"state": "MI",
"postal_code": "481781125",
"telephone_number": "248-486-4228"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "35425 W MICHIGAN AVE",
"city": "WAYNE",
"state": "MI",
"postal_code": "481841687",
"telephone_number": "734-729-7792"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHAKER",
"first_name": "THOMAS",
"middle_name": "MICHEAL",
"name_prefix": "Mr.",
"credential": "M.S. L.L.P.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-10-03",
"last_updated": "2007-10-03",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "MI",
"license": "6301008157",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wayne, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 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.