SCOTT MACINNIS (NPI# 1790148815) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790148815 |
| Entity Type | Individual |
| Full Name | SCOTT MACINNIS |
| Practice Address |
905 S Center St Royal Oak MI 48067-3230 |
| Mailing Address |
42307 Old Bridge Rd Canton MI 48188-1138 |
| Practice Telephone | 3134779403 |
| Mailing Telephone | 3134779403 |
| Enumeration Date | 2016-04-05 |
| Last Update Date | 2018-11-08 |
| NPI Deactivation Date | 10/07/2018 |
| NPI Reactivation Date | 2018-10-24 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
6301017666 | MI | Behavioral Health & Social Service Providers |
| N | 247200000X | Technician, Other | Technologists, Technicians & Other Technical Service Providers |
| Street Address |
905 S CENTER ST |
| City | ROYAL OAK |
| State | MI |
| Zip Code | 48067-3230 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891907838 | Henry M Traurig | Psychologist | 905 S Center St, Royal Oak, MI 48067-3230 | 2007-05-03 |
| 1265053029 | Henry M Traurig, PC | Psychologist | 905 S Center St, Royal Oak, MI 48067-3230 | 2020-05-04 |
| 1982147302 | Wise Mind Pllc | Clinic/Center | 905 S Center St, Royal Oak, MI 48067-3230 | 2016-12-02 |
| 1033595665 | Fairsky Foundation | Psychologist | 905 S Center St, Royal Oak, MI 48067-3230 | 2015-08-05 |
| 1881090587 | Nancy A Sparrow Lmsw LLC | Counselor | 905 S Center St, Royal Oak, MI 48067-3230 | 2014-11-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922609072 | George Edward Khamis | Psychologist | 25600 Woodward Avenue, Suite 215, Royal Oak, MI 48067 | 2020-11-05 |
| 1205443751 | Crossover Health Medical Group | Clinic/Center | 424 E. 4th St, Suite 100, Royal Oak, MI 48067 | 2020-09-29 |
| 1750917811 | Sonia B Shah-gonzalez | Case Management | 830 E Fourth St, #1, Royal Oak, MI 48067 | 2020-03-19 |
| 1568022960 | Woodo Pharmacy LLC | Pharmacy | 909 E 11 Mile Rd, Royal Oak, MI 48067 | 2019-06-18 |
| 1093217564 | Sharon Diane Malinowski | Occupational Therapist | 4949 Coolidge Hwy Section E, Adult Neuro Ot, Royal Oak, MI 48067 | 2018-03-01 |
| 1962916569 | Nuch of Michigan Inc | Clinic/Center | 2140 E 12 Mile Rd, Royal Oak, MI 48067 | 2017-11-20 |
| 1629420179 | Christine Paige | Homeopath | 1112 Catalpa, Royal Oak, MI 48067 | 2016-07-08 |
| 1104277045 | Rppc Labs, LLC | Clinical Medical Laboratory | 26154 Woodward Ave Ste 5, Royal Oak, MI 48067 | 2016-06-22 |
| 1346606423 | Thomas Michalos | Counselor | 402 S. Lafayette, Royal Oak, MI 48067 | 2016-01-05 |
| 1508234212 | Valetta Aldridge | Registered Nurse | 28000 Woodward, Royal Oak, MI 48067 | 2015-09-11 |
| Find all providers in zip 48067 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013527134 | Lindsey L Bupp | Psychologist | 3007 N Altadena Ave, Royal Oak, MI 48073-3555 | 2020-08-04 |
| 1144711102 | Stephen Roger Fleck | Psychologist | 221 Forest Ave, Royal Oak, MI 48067-1876 | 2018-05-25 |
| 1407145030 | Andrea Nicole Morrison | Psychologist | 221 S Main St Ste 201, Royal Oak, MI 48067-2653 | 2011-04-05 |
| 1699076950 | Carole E. West | Psychologist | 603 N Gainsborough Ave, Royal Oak, MI 48067-1938 | 2010-11-03 |
| 1558675355 | Debra Ann Harmon | Psychologist | 1812 Harwood Ave, Royal Oak, MI 48067-4064 | 2010-08-04 |
| 1740411297 | Christine Catherine Elwart | Psychologist | 2007 Roseland Ave, Royal Oak, MI 48073-5014 | 2009-07-31 |
| 1578738431 | Judy Leigh Atkins | Psychologist | 26862 Woodward Ave, Suite 102, Royal Oak, MI 48067-0957 | 2008-04-22 |
| 1518089705 | Janice Gail Tomakowsky | Psychologist | 333 W 7th St, Suite 220, Royal Oak, MI 48067-2513 | 2007-04-06 |
| 1700900529 | Joe Bavonese | Psychologist | 27172 Woodward, Suite 200, Royal Oak, MI 48067-0965 | 2007-03-19 |
| 1093821597 | Daniel Charles Stettner Lp | Psychologist | 30701 Woodward Ave Ste 200, Royal Oak, MI 48073 | 2006-08-21 |
| Find all providers in ROYAL OAK | ||||
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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.