Ronald Lewis Michelini, PHD
Individual provider Active NPI Clinical Psychologist · Elma, NY
NPI 1962597567 · NPPES record last updated Jan 23, 2009
Key facts
- NPI
- 1962597567
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Psychologist 103TC0700X
- License
- 008012-1 (NY)
- Practice address
- 960 West Maple Court
Suburban Adult Services, Inc
Elma, NY 14059 - Phone
- (716) 805-1555
- Fax
- (716) 805-1444
- NPI assigned
- Oct 3, 2006
- 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)
- Yes
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 8012 | NY | MD | Psychologist |
| 008012-1 | NY | MD | Occupational Therapy Assistant |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 8012 | NY | |
| Clinical Psychologist | 103TC0700X | 008012-1 | NY | Yes |
Addresses
Primary practice location
960 West Maple Court
Suburban Adult Services, Inc
Elma, NY 14059
Mailing address
127 Winston Rd
Buffalo, NY 14216
Phone (716) 832-5473
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000512621001 | Other | NY | BLUE CROSS/BLUE SHIELD |
| 620003604 | Other | NY | MEDICARE RAILROAD |
Other providers in Elma, NY
- Joshua David Magier
- Ellen L Marrone
- Michele A Matala
- James F May
- Adam McCrea
- Devon Leigh Milbrand
- Patricia Miller
- Tracy Ann Miller
- Laura Beth Monheim
- Morgan Integrated Chiropractic Services
All providers in Elma, NY · Clinical Psychologist in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 23, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.