MICHELLE M ROUSSEAU (PSY.D.) – Clinical Psychologist, NPI 1366555286

MICHELLE M ROUSSEAU (PSY.D.) is a healthcare provider. based in Port huron, Michigan. specializing in CLINICAL PSYCHOLOGIST. They hold the professional credentials PSY.D.. They hold a License No. 6301012660 (MI). The NPI Number for MICHELLE M ROUSSEAU (PSY.D.) is 1366555286

Main info

Female
22 Years Of Experience
Accepts Medicare Assignment
Name
MICHELLE M ROUSSEAU (PSY.D.)
NPI
1366555286
Phone
(810) 984-4202
Address
520 SUPERIOR ST
Enumeration Date
16 August 2006
Last Update Date
8 July 2007

Doctor Profile

Medical School Name
OTHER
Secondary Phone
-
Graduation Year
2004 (22 years ago)
PAC ID
6507968716
Group Practice PAC ID
2062511934
Professional Enrollment ID
I20070219000394
Address ID
MI480401145MA1600XBXXX500
Telehealth
Yes
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness75
Years active:19State licenses:1Digital endpointsOther names

1,216 CLINICAL PSYCHOLOGIST in MI

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Provider Addresses for MICHELLE M ROUSSEAU (PSY.D.)

  • 520, Superior Street, Port Huron, Saint Clair County, Michigan, 48060, United States

    PORT HURON, MI 480603838

    Phone: (810) 984-4202

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2007-02-19

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20070219000394IClinical PsychologistMITBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 48060)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 2062511934View full group profile
NameSpecialtyState
Clinical Social WorkerMI
Clinical PsychologistMI

Reviews

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Frequently asked questions

What is the registry number for MICHELLE M ROUSSEAU (PSY.D.)?
The registry entry for MICHELLE M ROUSSEAU (PSY.D.) shows NPI 1366555286.
Is MICHELLE M ROUSSEAU (PSY.D.) currently accepting referrals based on NPI status?
Registry metadata lists MICHELLE M ROUSSEAU (PSY.D.) as active.
What services align with MICHELLE M ROUSSEAU (PSY.D.)'s listing?
MICHELLE M ROUSSEAU (PSY.D.)'s public classification highlights Clinical Psychologist. Clinical services aligned with this taxonomy classification.
Which community is linked to MICHELLE M ROUSSEAU (PSY.D.)?
MICHELLE M ROUSSEAU (PSY.D.) shows a connection to Port Huron, Michigan in registry-derived data.
Why is information missing for MICHELLE M ROUSSEAU (PSY.D.)?
Providers choose how much contact data to publish. Missing fields do not mean the profile is fake.

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