Greig Spodarek, MA

Primary specialty

Cognitive & Behavioral PsychologistTaxonomy code 103TB0200X

License

6301003937 Issued in MI

Practice address

1450 S Lapeer Rd
Oxford, MI 48371-6108

Phone

(248) 969-9932

Fax

(248) 969-3006

NPI assigned

Oct 26, 2009

Last updated

Oct 26, 2009By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

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

{
    "created_epoch": "1256515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1256515200000",
    "number": "1871829952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1450 S LAPEER RD",
            "city": "OXFORD",
            "state": "MI",
            "postal_code": "483716108",
            "telephone_number": "248-969-9932",
            "fax_number": "248-969-3006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1450 S LAPEER RD",
            "city": "OXFORD",
            "state": "MI",
            "postal_code": "483716108",
            "telephone_number": "248-969-9932",
            "fax_number": "248-969-3006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPODAREK",
        "first_name": "GREIG",
        "credential": "MA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-10-26",
        "last_updated": "2009-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": "MI",
            "license": "6301003937",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSED PSYCOLOGIST",
            "identifier": "6301003937",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Cognitive & Behavioral Psychologist in Oxford, MI
• Providers in Oxford, MI by specialty
• Cognitive & Behavioral Psychologist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 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.