NPIMap

Organization Active NPI

Robert J Flewelling PSYD PLLC

  • Clinical Psychologist
  • Royal Oak, MI
National Provider Identifier
1811219678
Registry record updated Dec 3, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
6301014084 Issued in MI
Legal business name
ROBERT J FLEWELLING PSYD PLLC
Practice address
2011 Crooks Rd
Royal Oak, MI 48073-4049
Phone
(248) 980-7997
NPI assigned
Feb 22, 2010
Last updated
Dec 3, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2012

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

Authorized official

Name
Dr. Robert J Flewelling, PSYD LPNPI 1386967743
Title
Ceo
Phone
(248) 980-7997

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 6301014084 MI Primary

Addresses

Primary practice location

2011 Crooks Rd
Royal Oak, MI 48073-4049

Mailing address

247 Holmur Dr
Waterford, MI 48327-3621
Phone (248) 980-7997

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20101116000114 MI Part B Supplier - Clinic/Group Practice 0749475754 Receives reassigned benefits from 10 practitioners
Practice locations: Royal Oak, MI; West Bloomfield, MI

National Provider Directory

National Provider Directory

Locations

1463 E 12 Mile Rd
Madison Heights, MI 48071
Phone (248) 414-3382

5757 W Maple Rd
Ste 800B
West Bloomfield, MI 48322
Phone (248) 633-8576

Practitioners & affiliated clinicians

Practitioners 12

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.

NPI Registry JSON

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

{
    "created_epoch": "1266796800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1354492800000",
    "number": "1811219678",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "247 HOLMUR DR",
            "city": "WATERFORD",
            "state": "MI",
            "postal_code": "483273621",
            "telephone_number": "248-980-7997"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2011 CROOKS RD",
            "city": "ROYAL OAK",
            "state": "MI",
            "postal_code": "480734049",
            "telephone_number": "248-980-7997"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROBERT J FLEWELLING PSYD PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-02-22",
        "last_updated": "2012-12-03",
        "status": "A",
        "authorized_official_last_name": "FLEWELLING",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "248-980-7997",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSYD LP"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6301014084",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Royal Oak, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.