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Sean Michael Dougherty , MA LLP

Psychologist β€’ Ada, MI

Active NPI 1902841968 Individual Practitioner Male Practitioner
Practice location in NPPES

967 Spaulding Ave Se Ste E
Ada, MI 493013703

Call 6165041002 Location details and other listings
Medical Disclaimer

This profile restates public CMS/NPPES data; T-MedInfo gives no medical advice — consult a licensed professional, and call 911 for emergencies.

Practice Location & Contact Primary Location

Practice Address

967 Spaulding Ave Se Ste E

Ada, MI 493013703

Telephone 6165041002
Fax 6167194480
Organization at the Same NPPES Address or Phone
Dawn Jenkins Lmsw Facility NPI 1790375590

Matched by practice address or phone in NPPES. A shared address or phone does not confirm that this clinician works there.

NPI first issued

2006

The year this clinician's National Provider Identifier (NPI) was issued. An NPI is a unique 10-digit ID that US health care providers use for billing.

What this does not show: NPI first issued

NPIs have been issued only since 2005, so this year is not necessarily when the clinician started practicing.

Source: CMS NPPES NPI Registry.

Medicare assignment not listed

CMS data do not show whether this clinician accepts Medicare assignment. This does not mean they do not accept Medicare. Ask the office.

Medicare assignment applies to Original Medicare. It does not tell you whether the clinician is in a Medicare Advantage plan's network, accepts other insurance, or is taking new patients.

Source: CMS Doctors and Clinicians; Medicare.gov, β€œDoes your provider accept Medicare as full payment?”

Guide: What Medicare assignment means

No telehealth indicator

CMS shows this indicator only when recent Medicare claims include telehealth services. The clinician may still offer telehealth; ask the office.

Source: CMS, Telehealth Indicator on Medicare Care Compare (fact sheet, January 2023); CMS Doctors and Clinicians.

Guide: How Medicare covers telehealth

Compared with the same specialty in Ada and Michigan

10 active clinicians are listed under Psychologist with a practice address in Ada, MI (2,549 in Michigan).

Addresses are self-reported to NPPES and may be out of date.

Sources: CMS Doctors and Clinicians, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.

Text: T-MedInfo Β· Report an error.

Specialties & License Numbers Reported to NPPES

Self-certified to NPPES: 2023-10-03
Psychologist Primary Specialty

NUCC Taxonomy Code: 103T00000X

License # reported to NPPES MI 6301009294

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.

Check License Status with the State Board License numbers are self-reported to NPPES; T-MedInfo does not confirm them against state records. Current status: Michigan Department of Licensing and Regulatory Affairs.
Look Up on State Board Site

Clinicians Sharing This Practice Address or Phone

Clinicians sharing this NPPES address, phone or fax; a shared contact does not mean they work together.

2 listed
Dr. Philip Fox , MD

Psychiatry & Neurology - Psychiatry

NPI 1013976596

Doctor of Medicine (M.D.)

Dr. Henry Mulder , MD

Psychiatry & Neurology - Psychiatry

NPI 1881617439

Doctor of Medicine (M.D.)

Career & Practice History Timeline

Changes recorded in monthly NPPES data files: addresses, names, credentials, specialties and NPI status

13 Historical Events
πŸ“
Updated Practice Location December 13, 2023

Registered at 967 SPAULDING AVE SE STE E, ADA, MI 493013703 (Tel: 6165041002)

πŸ“
Updated Business Mailing Address December 13, 2023

Registered at 967 SPAULDING AVE SE STE E, ADA, MI 493013703 (Tel: 6165041002)

βœ…
NPI Profile Active June 15, 2017

NPI status registered as active in NPPES database

πŸ“
Updated Practice Location June 15, 2017

Registered at 5060 CASCADE RD. SE, SUITE D, GRAND RAPIDS, MI 49546 (Tel: 6164542911)

πŸ“
Updated Business Mailing Address June 15, 2017

Registered at 5060 CASCADE RD. SE, SUITE D, GRAND RAPIDS, MI 49546 (Tel: (616) 454-2911)

πŸ‘€
Provider Name / Credentials Updated June 15, 2017

Recorded as SEAN DOUGHERTY, MA LLP

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) June 15, 2017

Psychologist (license number reported to NPPES: MI 6301009294)

βœ…
NPI Profile Active June 25, 2010

NPI status registered as active in NPPES database

πŸ“
Practice Location (Initial Record) June 25, 2010

Registered at 1403 60TH ST SE, KENTWOOD, MI 495087065 (Tel: 6167194488)

πŸ“
Business Mailing Address (Initial Record) June 25, 2010

Registered at 1403 60TH ST SE, KENTWOOD, MI 495087065 (Tel: 6167194488)

πŸ‘€
Provider Name / Credentials (Initial Record) June 25, 2010

Recorded as SEAN DOUGHERTY, MA, LLP

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) June 25, 2010

Psychologist (license number reported to NPPES: MI 6301009294)

🟒
Initial NPI Registration & Enumeration June 16, 2006

First registered as active Individual Practitioner in NPPES Database.

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NPI Administrative Meta

NPI Number: 1902841968
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: June 16, 2006
Last Update: December 13, 2023
Sole Proprietor: Yes

Mailing Address

967 Spaulding Ave Se Ste E

Ada, MI 493013703

Phone: 6165041002

About This Data NPPES fields (address, phone, specialty, license) are self-reported and may be outdated; Medicare fields follow the CMS dataset named in each section. Correct directly at NPPES.