Dr Terry Lee Rudolph, PHD - Psychologist in Roseville, MI

Dr Terry Lee Rudolph, PHD is a Psychologist - Clinical based in Roseville, Michigan. Dr Terry Lee Rudolph is licensed to practice in Michigan (license number 003357) and his current practice location is 25779 Kelly Road, Roseville, Michigan. He can be reached at his office (for appointments etc.) via phone at (586) 774-7987.

NPI number for Dr Terry Lee Rudolph is 1154320489 and his current mailing address is 25779 Kelly Road, Roseville, Michigan. He does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1154320489.

Contact Information

Dr Terry Lee Rudolph, PHD
25779 Kelly Road,
Roseville, MI 48066-4973
(586) 774-7987
(586) 774-7263

Map and Direction




Healthcare Provider's Profile

Full NameDr Terry Lee Rudolph
GenderMale
SpecialityPsychologist - Clinical
Location25779 Kelly Road, Roseville, Michigan
Accepts Medicare AssignmentsDoes not participate in Medicare Program. He may not accept medicare assignment.
  NPI Data:
  • NPI Number: 1154320489
  • Provider Enumeration Date: 07/19/2005
  • Last Update Date: 03/08/2011

Medical Identifiers

Medical identifiers for Dr Terry Lee Rudolph such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1154320489NPI-NPPES
68-0-E0-4564-0OtherMIBLUE CROSS/BLUE SHIELD

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
103T00000XPsychologist 6301003357 (Michigan)Secondary
103TC0700XPsychologist - Clinical 003357 (Michigan)Primary

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Terry Lee Rudolph is NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Dr Terry Lee Rudolph, PHD
25779 Kelly Road,
Roseville, MI 48066-4973

Ph: (586) 774-7987
Dr Terry Lee Rudolph, PHD
25779 Kelly Road,
Roseville, MI 48066-4973

Ph: (586) 774-7987

Reviews and Comments


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