Annette Renee Evans, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

6301012090 Issued in MI

Practice address

1042 N Milford Rd Ste 203
Milford, MI 48381-5109

Phone

(248) 684-6003

Fax

(248) 684-6007

NPI assigned

Sep 17, 2006

Sex

Female

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

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

Practice roles

Locations

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.

• Milford Psychological Services, PC

  • Clinical Psychologist
  • Milford, MI
  • NPI 1528116142
  Medicare reassignment NPD Authorized official
• Darcey L. Maher, PH.D., P.C.

  • Clinical Psychologist
  • Milford, MI
  • NPI 1922151042
  NPD (past)
• Tri Care PC

  dba Northland Clinic

  • Psychologist
  • Farmington Hills, MI
  • NPI 1588731756
  NPD (past)
• Tri-Care PC

  dba Northland Clinic

  • Community/Behavioral Health Agency
  • Farmington Hills, MI
  • NPI 1083873103
  NPD (past)

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

{
    "created_epoch": "1158451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1437436800000",
    "number": "1912004581",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1042 N MILFORD RD STE 203",
            "city": "MILFORD",
            "state": "MI",
            "postal_code": "483815109",
            "telephone_number": "248-684-6003",
            "fax_number": "248-684-6007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1042 N MILFORD RD STE 203",
            "city": "MILFORD",
            "state": "MI",
            "postal_code": "483815109",
            "telephone_number": "248-684-6003",
            "fax_number": "248-684-6007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVANS",
        "first_name": "ANNETTE",
        "middle_name": "RENEE",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-17",
        "last_updated": "2015-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6301012090",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS PIN",
            "identifier": "680F328270",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sandra Dorothy Dwyer, RPH
• Ryan Easton, DPT
• Naida Efendiyeva
• Riham Elrefai, PHARM D
• Erica McNeely, LLC (North Star Psychological Services)
• Michael Faff
• Katherine Ellen Faunce
• Adrian Fear, IBCLC
• Lora Catherine Fedeson, P.T., C.M.T.
• Susan L Fisher, MPT

• Clinical Psychologist in Milford, MI
• Providers in Milford, MI by specialty
• Clinical Psychologist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2015; 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.

Verify at the official NPI Registry.