Individual provider Active NPI

Jeffrey B Allen, MA, LLP

  • Psychologist
  • Clinton Township, MI
National Provider Identifier
1922232586
Registry record updated May 12, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
6301011288 Issued in MI
Practice address
35455 Garfield Rd
# C
Clinton Township, MI 48035-2236
Phone
(586) 792-5335
Fax
(586) 792-3061
NPI assigned
May 12, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 12, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 6301011288 MI Primary

Addresses

Primary practice location

35455 Garfield Rd
# C
Clinton Township, MI 48035-2236

Mailing address

28000 Dequindre Rd
Warren, MI 48092-2468
Phone (586) 753-0405

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
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
6301011288MIMDPsychologist

Interoperability endpoints

  • Direct secure messaging: jallen1159599@direct.hfhs.org

NPI Registry JSON

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

{
    "created_epoch": "1242086400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1242086400000",
    "number": "1922232586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28000 DEQUINDRE RD",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480922468",
            "telephone_number": "586-753-0405",
            "fax_number": "586-753-0404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35455 GARFIELD RD",
            "address_2": "# C",
            "city": "CLINTON TOWNSHIP",
            "state": "MI",
            "postal_code": "480352236",
            "telephone_number": "586-792-5335",
            "fax_number": "586-792-3061"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALLEN",
        "first_name": "JEFFREY",
        "middle_name": "B",
        "credential": "MA, LLP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-05-12",
        "last_updated": "2009-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MI",
            "license": "6301011288",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clinton Township, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 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.