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DR. THERESA I EGAN PHD
NPI 1790888352
Psychologist - Clinical in Southfield, MI

Active since September 07, 2006
17336 W 12 MILE RD STE 101, SOUTHFIELD, MI 48076(586) 610-4006 Get Directions Write a Review

NPPES record last updated: June 24, 2009. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dr. Theresa I Egan Phd NPPES

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

DR. THERESA I EGAN PHD (NPI 1790888352) is an individual clinical provider in Southfield, Michigan, licensed in Michigan (6301011944) and active in the NPI registry since September 2006.

NPPES Registry Identity

NPI1790888352
Entity TypeIndividualFemale
Primary Taxonomy103TC0700X
Provider Legal NameDR. THERESA I EGANCredential: PHD
Location Address17336 W 12 MILE RD STE 101Southfield, MI 48076-2113
Mailing Address17336 W 12 Mile Rd Ste 101Southfield, MI 48076-2113 · (586) 610-4006
Phone(586) 610-4006
Sole ProprietorYes
Enumeration DateSeptember 7, 2006
Last NPPES UpdateJune 24, 2009
✔ NPI 1790888352 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychologist · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code103TC0700X
License✔ Licensed in MI · 6301011944
Definition
A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems.
17336 W 12 MILE RD STE 101, Southfield, MI 48076
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Other Identifiers 2

Medicare PIN0P16690004MI
Medicare ID-Type Unspecified0P16690004MI · Medicare

Other Providers at the Same Location NPPES

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

DR. GORDON E. MACKINNON PH. D.
Psychologist (Clinical)
17336 W 12 MILE RD STE 101
SOUTHFIELD, MI 48076
Oakland County (248) 583-9362

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 Theresa Egan's NPI number?

The NPI number for Theresa Egan is 1790888352. It was assigned to this individual provider in the NPPES registry on September 7, 2006.

Where is Theresa Egan located?

Theresa Egan practices at 17336 W 12 Mile Rd Ste 101, Southfield, MI 48076. The listed phone number is (586) 610-4006.

What is Theresa Egan's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.

When was this NPI record last updated?

The NPPES record for Theresa Egan was last updated on June 24, 2009. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 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.