CMS-1500 Box 24J / 33a • NPI
1861613887
Type 2 Organization (Box 32a/33a)
HIPAA NUCC Taxonomy • CMS Code
103TC2200X (CMS 62)
Licensed & Credentialed Behavioral Health & Social Service Providers — Psychologist, Clinical Child & Adolescent
Box 32 Service Location & ZIP+4
288 S MAIN ST, STE. 1, ROMEO, MI, 48065-5133
✓ 9-Digit EDI 837 ZIP+4 (48065-5133)
✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR:
NPI
1861613887 (CLAUDE W. EGGERTSEN, PHD, PLLC) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).
CMS Medicare Order & Referring PECOS Eligibility
Official CMS NPPES Credential & Practice Profile
| 10-Digit NPI Number | 1861613887 (NPI-2 Organization / Facility) |
|---|---|
| Provider / Legal Name | CLAUDE W. EGGERTSEN, PHD, PLLC |
| Plain-English Specialty | Licensed & Credentialed Behavioral Health & Social Service Providers — Psychologist, Clinical Child & Adolescent NUCC Code: 103TC2200X (Psychologist, Clinical Child & Adolescent) |
| Certifying / Licensing Body | State Medical / Healthcare Licensing Board & National Specialty Board |
| Practice Location Address | 288 S MAIN ST, STE. 1, ROMEO, MI, 48065-5133 |
| Practice Telephone / Fax | Tel: (586) 752-0091 | Fax: (586) 677-7809 |
| Administrative Mailing Address | PO BOX 747, WASHINGTON, MI, 48094-0747 |
| Enumeration & Last Sync | Enumerated: 2007-05-01 | CMS Record Updated: 2025-09-11 |
| Authorized Official | CLAUDE EGGERTSEN (President, owner) |
Clinic Location, Accessibility & Directions
📍 Practice Location & Patient Access
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Plain-English Taxonomy & CMS Crosswalk (103TC2200X)
What Does Taxonomy Code 103TC2200X Mean?
In the HIPAA National Uniform Claim Committee (NUCC) classification, code 103TC2200X translates to:
"Licensed & Credentialed Behavioral Health & Social Service Providers — Psychologist, Clinical Child & Adolescent"
Specialty Clinical Procedures & Therapeutic Classes
Standard Scope of Care (CLAUDE W. EGGERTSEN, PHD, PLLC)
Typical CPT / Diagnostic Procedures:- Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
- Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
- Preventive Screening, Patient Counseling & Multidisciplinary Referral
- Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)
All Registered NUCC Taxonomies & State Licenses
| Taxonomy Code & Plain-English Description | State License & Primary Status |
|---|---|
103G00000X — Clinical NeuropsychologistPlain English: Licensed & Credentialed Clinical Neuropsychologist | State: N/A | License: Verified | Primary: Secondary |
103T00000X — PsychologistPlain English: Licensed & Credentialed Behavioral Health & Social Service Providers — Psychologist | State: N/A | License: Verified | Primary: Secondary |
103TA0400X — Psychologist, Addiction (Substance Use Disorder)Plain English: Licensed & Credentialed Behavioral Health & Social Service Providers — Psychologist, Addiction (Substance Abuse Disorder) | State: N/A | License: Verified | Primary: Secondary |
103TC2200X — Psychologist, Clinical Child & AdolescentPlain English: Licensed & Credentialed Behavioral Health & Social Service Providers — Psychologist, Clinical Child & Adolescent | State: N/A | License: Verified | Primary: Yes (Primary) |
Medical Billing, RCM & Hospital Credentialing Teams:
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