Active NPI
Hannah Ethridge
- Psychologist
- Bingham Farms, MI
National Provider Identifier
1861335846
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 6352001142
- Practice address
- 30200 Telegraph Rd Ste 207
Bingham Farms, MI 48025-5711 - Phone
- (248) 712-1129
- Fax
- (248) 792-3249
- NPI assigned
- Apr 13, 2026
- 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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | 6352001142 | MI | Primary |
Addresses
Primary practice location
30200 Telegraph Rd Ste 207
Bingham Farms, MI 48025-5711
Mailing address
3216 Holbrook St Apt 2F
Hamtramck, MI 48212-3952
Phone (248) 712-1129
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6352001142 | MI | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1776038400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1776038400000",
"number": "1861335846",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3216 HOLBROOK ST APT 2F",
"city": "HAMTRAMCK",
"state": "MI",
"postal_code": "482123952",
"telephone_number": "248-712-1129",
"fax_number": "248-792-3249"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "30200 TELEGRAPH RD STE 207",
"city": "BINGHAM FARMS",
"state": "MI",
"postal_code": "480255711",
"telephone_number": "248-712-1129",
"fax_number": "248-792-3249"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ETHRIDGE",
"first_name": "HANNAH",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2026-04-13",
"last_updated": "2026-04-13",
"certification_date": "2026-04-13",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Psychologist",
"state": "MI",
"license": "6352001142",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bingham Farms, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.