Active NPI
Nathan Hayrynen
- Cognitive & Behavioral Psychologist
- Southgate, MI
National Provider Identifier
1881176089
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Cognitive & Behavioral Psychologist
- License
- 6301016836
- Practice address
- 13101 Allen Rd
Southgate, MI 48195-2216 - Phone
- (734) 785-7700
- NPI assigned
- Sep 4, 2018
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Cognitive & Behavioral Psychologist | 103TB0200X | 6301016836 | MI | Primary |
Addresses
Primary practice location
13101 Allen Rd
Southgate, MI 48195-2216
Mailing address
31120 Wildwood St Apt 5304
Wixom, MI 48393-2624
Phone (517) 512-0705
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 |
|---|---|---|---|
| 6301016836 | MI | MD | Cognitive & Behavioral Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fenton Therapy Services LLC | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Psychologist
- Fenton, MI
- NPI 1548759541
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1536019200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1536019200000",
"number": "1881176089",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "31120 WILDWOOD ST APT 5304",
"city": "WIXOM",
"state": "MI",
"postal_code": "483932624",
"telephone_number": "517-512-0705"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13101 ALLEN RD",
"city": "SOUTHGATE",
"state": "MI",
"postal_code": "481952216",
"telephone_number": "734-785-7700"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HAYRYNEN",
"first_name": "NATHAN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2018-09-04",
"last_updated": "2018-09-04",
"status": "A"
},
"taxonomies": [
{
"code": "103TB0200X",
"taxonomy_group": "",
"desc": "Psychologist, Cognitive & Behavioral",
"state": "MI",
"license": "6301016836",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Southgate, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.