Daniel R. Bristol, M.A.

Key facts

NPI

1922446905

Entity type

Individual (NPI type 1)

Primary specialty

Clinical Psychologist 103TC0700X

License

6301003981 (MI)

Practice address

1655 E Caro Rd
Caro, MI 48723-9319

Phone

(989) 673-2500

NPI assigned

Jun 12, 2013

Sex

Male

Sole proprietor

No

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

No

Credentials

Master of Arts

State licenses

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jun 12, 2013.

{
    "created_epoch": "1370995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1370995200000",
    "number": "1922446905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1655 E CARO RD",
            "city": "CARO",
            "state": "MI",
            "postal_code": "487239319",
            "telephone_number": "989-673-2500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1655 E CARO RD",
            "city": "CARO",
            "state": "MI",
            "postal_code": "487239319",
            "telephone_number": "989-673-2500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRISTOL",
        "first_name": "DANIEL",
        "middle_name": "R.",
        "name_prefix": "Mr.",
        "credential": "M.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-06-12",
        "last_updated": "2013-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6301003981",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Caro, MI

• Yagnesh Kiritkumar Brahmbhatt, RPT
• Sherri Brandt, B.S., M.P.T.
• Laura M Breidinger, PA
• Makayla Linn Brindley, FNP-BC
• Danielle Ann Briolat, RPH
• Katherine Bristol, MSW, LMSW
• Benjamin Brown
• Laura J Brown, MA,LPC,CAADC
• Kirsten Saryssa Brydon, OTR/L
• Chelsea Buhl, LLMSW

All providers in Caro, MI · Clinical Psychologist in Michigan