Neurocognitive Center of Michigan Group

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

Legal business name

NEUROCOGNITIVE CENTER OF MICHIGAN GROUP

Practice address

28800 Ryan Rd
Suite 300
Warren, MI 48092-4272

Phone

(586) 582-0500

Fax

(586) 620-8113

NPI assigned

Mar 11, 2015

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Mohamad K Altabba, MBA

Title

President/Director

Phone

(586) 582-0500

Specialties & licenses 6

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1426032000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1426032000000",
    "number": "1033502224",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28800 RYAN RD",
            "address_2": "SUITE 300",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480924272",
            "telephone_number": "586-582-0500",
            "fax_number": "586-620-8113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28800 RYAN RD",
            "address_2": "SUITE 300",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480924272",
            "telephone_number": "586-582-0500",
            "fax_number": "586-620-8113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEUROCOGNITIVE CENTER OF MICHIGAN GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-03-11",
        "last_updated": "2015-03-11",
        "status": "A",
        "authorized_official_last_name": "ALTABBA",
        "authorized_official_first_name": "MOHAMAD",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "PRESIDENT/DIRECTOR",
        "authorized_official_telephone_number": "586-582-0500",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MBA"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joseph Nelson
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• Charlotte Anne Neme, MSW
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• Sara Lynn Neumann
• Neurocognitive Center of Michigan Inc.
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• New Health Chiropractic Care PC
• New Passion Health Care PLLC

• Psychiatry Physician in Warren, MI
• Providers in Warren, MI by specialty
• Psychiatry Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.