| Demetrius Edwin Ford, LP, PHD | |
|
21 Kercheval Ave Ste 371, Grosse Pointe Farms, MI 48236-3698 | |
| (313) 806-9535 | |
| Not Available |
| Full Name | Demetrius Edwin Ford |
|---|---|
| Gender | Male |
| Speciality | Psychologist - Clinical |
| Location | 21 Kercheval Ave Ste 371, Grosse Pointe Farms, Michigan |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376699801 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | 6301009054 (Michigan) | Secondary |
| 103TC0700X | Psychologist - Clinical | 6301018364 (Michigan) | Primary |
| Entity Name | Ascension Eastwood Behavioral Health |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1396787701 PECOS PAC ID: 2163324492 Enrollment ID: O20040126000572 |
| Entity Name | Triton Behavorial Health Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1205337722 PECOS PAC ID: 8123436557 Enrollment ID: O20210422002793 |
| Entity Name | Social Care Administrators, Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1487916433 PECOS PAC ID: 7719370923 Enrollment ID: O20220211000804 |
| Mailing Address | Practice Location Address |
|---|---|
| Demetrius Edwin Ford, LP, PHD 21 Kercheval Ave Ste 317, Grosse Pointe Farms, MI 48236-3698 Ph: (313) 806-9535 | Demetrius Edwin Ford, LP, PHD 21 Kercheval Ave Ste 371, Grosse Pointe Farms, MI 48236-3698 Ph: (313) 806-9535 |
Shanae Nyanankpe, MA Psychologist Medicare: Not Enrolled in Medicare Practice Location: 18640 Mack Ave, Grosse Pointe Farms, MI 48236 Phone: 313-744-3220 | |
Diane Mccormack, PH.D. Psychologist Medicare: Not Enrolled in Medicare Practice Location: 366 Belanger St, Grosse Pointe Farms, MI 48236 Phone: 313-885-1385 Fax: 313-884-6432 | |
Judy Gilbert, LLP Psychologist Medicare: Not Enrolled in Medicare Practice Location: 188 Lakeview Ave, Grosse Pointe Farms, MI 48236 Phone: 313-618-2800 | |
Mr. Mark Rene Desroberts, M.A.,L.L.P. Psychologist Medicare: Not Enrolled in Medicare Practice Location: 159 Kercheval Ave, Grosse Pointe Farms, MI 48236 Phone: 313-640-2217 | |
Dr. Lisa A Medoff, PH.D. Psychologist Medicare: Not Enrolled in Medicare Practice Location: 440 Madison St, Grosse Pointe Farms, MI 48236 Phone: 248-854-9573 | |
Robert Auedis Papazian, PSY.D Psychologist Medicare: Accepting Medicare Assignments Practice Location: 131 Kercheval Ave, Suite 390, Grosse Pointe Farms, MI 48236 Phone: 313-885-6400 Fax: 313-885-6807 |