Provider Demographics
NPI:1740263516
Name:SOMMERSCHIELD, HAROLD STANLEY (PH D)
Entity type:Individual
Prefix:DR
First Name:HAROLD
Middle Name:STANLEY
Last Name:SOMMERSCHIELD
Suffix:
Gender:M
Credentials:PH D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:575 S LAKE HURON SHORE DR
Mailing Address - Street 2:
Mailing Address - City:HARRISVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:48740-9588
Mailing Address - Country:US
Mailing Address - Phone:989-724-3331
Mailing Address - Fax:989-724-6334
Practice Address - Street 1:575 S LAKE HURON SHORE DR
Practice Address - Street 2:
Practice Address - City:HARRISVILLE
Practice Address - State:MI
Practice Address - Zip Code:48740-9588
Practice Address - Country:US
Practice Address - Phone:989-724-3331
Practice Address - Fax:989-724-6334
Is Sole Proprietor?:No
Enumeration Date:2005-11-24
Last Update Date:2024-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301000905103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI68-(OB54508)OtherBLUE CROSS
MI680B545080Medicare ID - Type Unspecified