BETHANY S GOURLEY (NPI# 1538784012) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1538784012 |
| Entity Type | Individual |
| Full Name | BETHANY S GOURLEY |
| Credential | PH.D. |
| Practice Address |
19855 Outer Dr Ste 300 Dearborn MI 48124-2022 |
| Practice Telephone | 3133591977 |
| Mailing Telephone | 3133591977 |
| Enumeration Date | 2020-06-10 |
| Last Update Date | 2020-06-10 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103T00000X | Psychologist | 6301018150 | MI | Behavioral Health & Social Service Providers |
| Street Address |
19855 OUTER DR STE 300 |
| City | DEARBORN |
| State | MI |
| Zip Code | 48124-2022 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841802469 | Corryn Helen Jackson | Counselor | 19855 Outer Dr Ste 300, Dearborn, MI 48124-2022 | 2020-08-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396389524 | Pharma A, LLC | Pharmacy | 23916 Michigan Ave, Dearborn, MI 48124 | 2019-10-31 |
| 1225683725 | Aysha Said | Behavior Technician | 1369 Porter St, Dearborn, MI 48124 | 2019-08-02 |
| 1881257772 | Leen Nusairat | Internal Medicine | Beaumont Health-dearborn Campus, 18101 Oakwood Blvd, Dearborn, MI 48124 | 2019-04-17 |
| 1417413360 | Gary C. Veraghen, Dds, PC | Dentist | 22100 W. Outer Drive, Dearborn, MI 48124 | 2019-02-15 |
| 1982168787 | Fnu Asma Manzar | Physical Therapist | Global Physical Therapy Services, Inc, 22819 Michigan Avenue, Dearborn, MI 48124 | 2019-01-25 |
| 1639640162 | Jernia Lashawn Usher | Behavior Technician | 1360 Porter St Lower Level, Dearborn, MI 48124 | 2018-12-10 |
| 1710456470 | Samar Fouad Hannawi | Psychologist | 3815 Pelham Street, Suite #13, Dearborn, MI 48124 | 2018-11-24 |
| 1881178747 | Sarah Chehab | Psychologist | 835 Mason St Suite 220b, Dearborn, MI 48124 | 2018-09-17 |
| 1568948289 | Ibrahim M Basma | Pharmacist | 22521 Michigan Avenue, Dearborn, MI 48124 | 2018-07-16 |
| 1669961942 | Jacqueline E Domzalski | Technician, Other | 3231 S. Gulley, Suite E, Dearborn, MI 48124 | 2018-05-02 |
| Find all providers in zip 48124 | ||||
| Taxonomy Code | 103T00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public. |
| Notes: Source: American Psychological Association [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710456470 | Samar Fouad Hannawi | Psychologist | 3815 Pelham Street, Suite #13, Dearborn, MI 48124 | 2018-11-24 |
| 1750737284 | Emma Van Hoet | Psychologist | Great Lakes Psychology Group, 1 Parklane Boulevard Suite 1200e, Dearborn, MI 48126 | 2016-05-13 |
| 1245603711 | Amani Fadlallah | Psychologist | 5286 Williamson, Dearborn, MI 48126 | 2015-11-05 |
| 1619316510 | Barbara V Travis | Psychologist | 2881 Monroe St Ste 201, Dearborn, MI 48124-3475 | 2013-06-24 |
| 1336495746 | Jason David Majchrzak | Psychologist | 18501 Rotunda Dr Ste 100, Dearborn, MI 48124-3891 | 2012-08-03 |
| 1407150295 | Dustin Marsh | Psychologist | 19044 Outer Dr, Dearborn, MI 48128 | 2011-01-07 |
| 1275869109 | Marilyn Kay Gerwolls | Psychologist | 7467 Bingham St, Dearborn, MI 48126-1428 | 2009-10-28 |
| 1467578286 | Kathleen Mary Kalil | Psychologist | 24940 Fairmount Dr, Dearborn, MI 48124-1584 | 2007-03-22 |
| 1528197928 | Sandra L Parent | Psychologist | 806 Oakwood Blvd, Dearborn, MI 48124-2319 | 2007-03-04 |
| 1770640252 | Vanessa Charnock | Psychologist | 835 Mason St Ste B220, Dearborn, MI 48124-2262 | 2007-01-03 |
| Find all providers in DEARBORN | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.