Reginald E Marsack, LLP

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

6301007086 Issued in MI

Practice address

33101 Annapolis St
Wayne, MI 48184-2405

Phone

(734) 721-0200

NPI assigned

Mar 16, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1142467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1952370579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33054 GRENNADA ST",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481544171",
            "telephone_number": "734-306-4427"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33101 ANNAPOLIS ST",
            "city": "WAYNE",
            "state": "MI",
            "postal_code": "481842405",
            "telephone_number": "734-721-0200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARSACK",
        "first_name": "REGINALD",
        "middle_name": "E",
        "name_prefix": "Mr.",
        "credential": "LLP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6301007086",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maple Manor Rehabilitation Center LLC
• Kyle Marcelis
• Ashley Mariano, DPM
• Kynthia Marinkovich
• Kailah Marks
• Lawrence Alan Marten, M.D.
• Larry Martin Jr.
• Robert Henry Martin IV, MD
• Daraoun Mashrah, PHARMD
• Mary Anne Masiarak-Byars, LMSW

• Clinical Psychologist in Wayne, MI
• Providers in Wayne, 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 8, 2007; 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.