Active NPI
Susan Greenshields, PH.D.
- Clinical Psychologist
- Dearborn, MI
National Provider Identifier
1821077082
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 6301007742
- Practice address
- 19855 Outer Dr
Suite 103a
Dearborn, MI 48124-2022 - Phone
- (313) 359-3676
- NPI assigned
- Jan 15, 2006
- Sex
- Female
- Sole proprietor
- Yes
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 | 6301007742 | MI | Primary |
Addresses
Primary practice location
19855 Outer Dr
Suite 103a
Dearborn, MI 48124-2022
Mailing address
19855 Outer Dr
Suite 103a
Dearborn, MI 48124-2022
Phone (313) 359-3676
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20110211001008 | MI | Practitioner - Clinical Psychologist | 8921288697 | Practice locations: Dearborn, MI |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Other, 1992
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
19855 Outer Dr
Suite 103a
Dearborn, MI 48124-2022
Phone (313) 359-3676
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6301007742 | MI | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1137283200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1193788800000",
"number": "1821077082",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "19855 OUTER DR",
"address_2": "SUITE 103A",
"city": "DEARBORN",
"state": "MI",
"postal_code": "481242022",
"telephone_number": "313-359-3676"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "19855 OUTER DR",
"address_2": "SUITE 103A",
"city": "DEARBORN",
"state": "MI",
"postal_code": "481242022",
"telephone_number": "313-359-3676"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GREENSHIELDS",
"first_name": "SUSAN",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-01-15",
"last_updated": "2007-10-31",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "MI",
"license": "6301007742",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dearborn, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.