Individual provider Active NPI

Daniel Shaun Bingham, PSY.D.

  • Clinical Psychologist
  • Ann Arbor, MI
National Provider Identifier
1982843777
Registry record updated Oct 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
6301015753 Issued in MI
Practice address
3135 S State St Ste 108
Ann Arbor, MI 48108-1653
Phone
(734) 369-3180
NPI assigned
Feb 18, 2009
Last updated
Oct 31, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 31, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 071007832 IL
Clinical Psychologist 103TC0700X 6301015753 MI Primary

Addresses

Primary practice location

3135 S State St Ste 108
Ann Arbor, MI 48108-1653

Mailing address

3135 S State St Ste 108
Ann Arbor, MI 48108-1653
Phone (734) 369-3180

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140509000167 MI Practitioner - Clinical Psychologist 1658564224 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Cypress Counseling Center PCGroup PAC ID 3971736315, 4 clinicians

Practice addresses (Care Compare)

3135 S State St
Suite 108
Ann Arbor, MI 48108-1653
Phone (734) 369-3180

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
071007832ILMDClinical Psychologist
6301015753MIMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Cypress Counseling Center, P.C. Clinical CurrentSince May 1, 2014 Accepting new patients
Centennial Counseling Center, PC PastSince Feb 1, 2007 Accepting new patients

Locations

3135 S State St
Ste 108
Ann Arbor, MI 48108
Phone (734) 369-3180

3135 S State St
Ste 203
Ann Arbor, MI 48108
Phone (734) 369-3180

343 S Main St
Ste 209A
Ann Arbor, MI 48104
Phone (734) 369-3180

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1234915200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698710400000",
    "number": "1982843777",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3135 S STATE ST STE 108",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481081653",
            "telephone_number": "734-369-3180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3135 S STATE ST STE 108",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481081653",
            "telephone_number": "734-369-3180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BINGHAM",
        "first_name": "DANIEL",
        "middle_name": "SHAUN",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-02-18",
        "last_updated": "2023-10-31",
        "certification_date": "2023-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071007832",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6301015753",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ann Arbor, MI

Sources for this page

Verify at the official NPI Registry.