DR. ANN LOUISE DATE PSY.D.
NPI 1174746820
Psychologist in Midland, MI

Active since April 11, 2007PECOS Enrolled
720 W WACKERLY ST, SUITE 4, MIDLAND, MI 48640(989) 832-2165(989) 839-4376 Get Directions Write a Review

NPPES record last updated: March 16, 2021. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Mar 16, 2021, Aug 13, 2018 (2 updates tracked since 2018).

About Dr. Ann Louise Date Psy.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. ANN LOUISE DATE PSY.D. (NPI 1174746820) is an individual psychologist in Midland, Michigan, licensed in Michigan (6301009535) and active in the NPI registry since April 2007. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1174746820
Entity TypeIndividualFemale
Primary Taxonomy103T00000X
Provider Legal NameDR. ANN LOUISE DATECredential: PSY.D.
Location Address720 W WACKERLY ST, SUITE 4Midland, MI 48640-2769
Mailing AddressPo Box 2875Midland, MI 48641-2875 · (989) 832-2165
Fax(989) 839-4376
Sole ProprietorYes
Enumeration DateApril 11, 2007
Last NPPES UpdateMarch 16, 20212 updates tracked since enumeration
NPPES CertifiedMarch 16, 2021
✔ NPI 1174746820 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychologistBehavioral Health & Social Service Providers
Taxonomy Code103T00000X
License✔ Licensed in MI · 6301009535
Definition
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.
720 W WACKERLY ST, Midland, MI 48640

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Ann Louise Date Psy.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Ann Date reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Psychologist
720 W WACKERLY ST
Midland, MI 48640
  • Reassigned Medicare billing, Michigan enrollment
  • 38 clinicians in this Medicare group

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES 13

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Clinic/Center (Dental)
720 W WACKERLY ST
MIDLAND, MI 48640
Psychologist
720 W WACKERLY ST, SUITE 4
MIDLAND, MI 48640
Physician Assistant (Medical)
720 W WACKERLY ST, STE. 8
MIDLAND, MI 48640
Psychologist
720 W WACKERLY ST
MIDLAND, MI 48640
Psychologist (Clinical)
720 W WACKERLY ST
MIDLAND, MI 48640
Social Worker (Clinical)
720 W WACKERLY ST, STE 11
MIDLAND, MI 48640
Psychologist
720 W WACKERLY ST, SUITE 4
MIDLAND, MI 48640
Psychologist (Clinical)
720 W WACKERLY ST
MIDLAND, MI 48640

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Ann Date's NPI number?

The NPI number for Ann Date is 1174746820. It was assigned to this individual provider in the NPPES registry on April 11, 2007.

Where is Ann Date located?

Ann Date practices at 720 W Wackerly St Suite 4, Midland, MI 48640. The listed phone number is (989) 832-2165.

What is Ann Date's specialty?

The primary specialty registered for this NPI is Psychologist with taxonomy code 103T00000X.

Is Ann Date enrolled in Medicare?

Yes. Ann Date is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Ann Date's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Ann Date reassigns Medicare benefits to Partners In Change: Psychological & Community Services, Plc (Midland, MI). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Ann Date's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Ann Date was last updated on March 16, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.