Joseph C. Shoots, MA,TLLP,CAC-1

Primary specialty

PsychologistTaxonomy code 103T00000X

License

6361005620 Issued in MI

Practice address

6548 Town Center Dr
Clarkston, MI 48346-4823

Phone

(810) 488-0490

NPI assigned

Jun 26, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

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

{
    "created_epoch": "1151280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659916800000",
    "number": "1922035286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1214 BEEMER CT",
            "city": "OXFORD",
            "state": "MI",
            "postal_code": "483714802",
            "telephone_number": "810-488-0490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6548 TOWN CENTER DR",
            "city": "CLARKSTON",
            "state": "MI",
            "postal_code": "483464823",
            "telephone_number": "810-488-0490"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1214 Beemer Ct",
            "address_purpose": "LOCATION",
            "city": "Oxford",
            "state": "MI",
            "postal_code": "483714802",
            "country_code": "US",
            "telephone_number": "810-488-0490",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHOOTS",
        "first_name": "JOSEPH",
        "middle_name": "C.",
        "name_prefix": "Mr.",
        "credential": "MA,TLLP,CAC-1",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-26",
        "last_updated": "2022-08-08",
        "certification_date": "2022-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MI",
            "license": "6301013045",
            "primary": false
        },
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "MI",
            "license": "6301013045",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MI",
            "license": "6361005620",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stefanie Denise Sherman, M.D.
• Carl Bernard Shermetaro, DO
• Teri L Shermetaro, D.O.
• Cody William Shinavier, PMHNP-BC
• Jonathan Shook, PHD
• Emily Short, DMFT, LMFT
• Molly Shovan, LMSW
• Andrew Sidhu, MD
• Carolyn Siler, OTR
• Brooke Ashley Silverson, MA, LLC

• Psychologist in Clarkston, MI
• Providers in Clarkston, MI by specialty
• Psychologist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2022; 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.