Mark Brian Anderson, ED.D.
NPI 1952455123ActiveIndividual· Psychologist· Southfield, MI
Psychologist (ED.D.) in Southfield, Michigan, licensed in MI, with an NPI issued in January 2007. Enrolled in Medicare as practitioner - clinical psychologist.
Overview
| NPI | 1952455123 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | ED.D. |
| Sole proprietor | Yes |
| NPI issued | Jan 23, 2007 |
| Last updated in NPPES | Nov 6, 2017 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Psychologist Primary | 103T00000X | 6301011646 | MI |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Clinical Psychologist (MI) |
|---|
Education and affiliations
| Graduation year | 2000 |
|---|---|
| Medicare specialty | Clinical Psychologist |
| Telehealth | Offers telehealth |
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