NPIMap

Organization Active NPI

Andrea Andrzejczak PH.D.

  • Point of Service
  • Grosse Pointe Woods, MI
National Provider Identifier
1841436201
Registry record updated Jan 6, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Point of ServiceTaxonomy code 305S00000X
License
6301009783 Issued in MI
Legal business name
ANDREA ANDRZEJCZAK PH.D.
Practice address
20867 Mack Ave
Suite 4
Grosse Pointe Woods, MI 48236-1392
Phone
(313) 885-8350
Fax
(313) 885-8357
NPI assigned
Jan 6, 2009
Last updated
Jan 6, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2009

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

Authorized official

Name
Dr. Andrea Lynn Andrzejczak, PH.D.NPI 1568520559
Title
Clinical Psychologist
Phone
(313) 885-8350

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
Point of Service 305S00000X 6301009783 MI Primary

Addresses

Primary practice location

20867 Mack Ave
Suite 4
Grosse Pointe Woods, MI 48236-1392

Mailing address

20867 Mack Ave
Suite 4
Grosse Pointe Woods, MI 48236-1392
Phone (313) 885-8350

Other identifiers 3

IdentifierTypeStateIssuer
1B 680H230320OtherMIBLUE CROSS BLUE SHIELD
6301009783OtherMILICENSE NUMBER
1568520559OtherNPI

National Provider Directory

National Provider Directory

Locations

20867 Mack Ave
Ste 4
Grosse Pointe Woods, MI 48236
Phone (313) 885-8350

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1231200000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1231200000000",
    "number": "1841436201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20867 MACK AVE",
            "address_2": "SUITE 4",
            "city": "GROSSE POINTE WOODS",
            "state": "MI",
            "postal_code": "482361392",
            "telephone_number": "313-885-8350",
            "fax_number": "313-885-8357"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20867 MACK AVE",
            "address_2": "SUITE 4",
            "city": "GROSSE POINTE WOODS",
            "state": "MI",
            "postal_code": "482361392",
            "telephone_number": "313-885-8350",
            "fax_number": "313-885-8357"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANDREA ANDRZEJCZAK PH.D.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-01-06",
        "last_updated": "2009-01-06",
        "status": "A",
        "authorized_official_last_name": "ANDRZEJCZAK",
        "authorized_official_first_name": "ANDREA",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "CLINICAL PSYCHOLOGIST",
        "authorized_official_telephone_number": "313-885-8350",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "305S00000X",
            "taxonomy_group": "",
            "desc": "Point of Service",
            "state": "MI",
            "license": "6301009783",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "1B 680H230320",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "6301009783",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1568520559",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Grosse Pointe Woods, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2009; 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.