Individual provider Active NPI

Alyssa Suzanne Mull, CNM

  • Psychiatric/Mental Health Nurse Practitioner
  • Ferndale, MI
National Provider Identifier
1053509810
Registry record updated Oct 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
4704232789 Issued in MI
Practice address
1603 E 9 Mile Rd
Ferndale, MI 48220-2065
Phone
(248) 514-4955
NPI assigned
Oct 5, 2007
Last updated
Oct 14, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 4704232789 MI Primary
Advanced Practice Midwife 367A00000X 4704232789 MI

Addresses

Primary practice location

1603 E 9 Mile Rd
Ferndale, MI 48220-2065

Mailing address

21625 Erben St
Saint Clair Shores, MI 48081-2846
Phone (586) 360-3476

Other practice location 1

3535 W 13 Mile Rd Ste 140
Royal Oak, MI 48073-6770
Phone (248) 551-3000

Other practice location 2

3601 W 13 Mile Rd
Royal Oak, MI 48073-6712
Phone (248) 551-3000

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address amull441312@direct.beaumont.edu

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161206002223 MI Practitioner - Certified Nurse Midwife (CNM) 8022106996 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Midwife

State licenses

LicenseStateTypeSpecialty
4704232789MIMDAdvanced Practice Midwife

Practice roles

OrganizationSpecialtyStatusNew patients
Emotional Advantage LLC CurrentSince Oct 21, 2025 Accepting new patients
Beaumont Medical Group- Specialty Services CurrentSince Aug 17, 2025 Accepting new patients

Locations

28100 Grand River Ave
Ste 301
Farmington Hills, MI 48336
Phone (947) 521-1320

1603 E 9 Mile Rd
Ferndale, MI 48220
Phone (248) 514-4955

3535 W 13 Mile Rd
Ste 140
Royal Oak, MI 48073
Phone (248) 551-3000

3601 W 13 Mile Rd
Royal Oak, MI 48073

44201 Dequindre Rd
Troy, MI 48085
Phone (248) 471-8255

Interoperability endpoints

  • Direct secure messaging: amull1248008@epic00.shdirect.org
  • Direct secure messaging: amull441312@direct.beaumont.edu

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1191542400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760400000000",
    "number": "1053509810",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21625 ERBEN ST",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "480812846",
            "telephone_number": "586-360-3476"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1603 E 9 MILE RD",
            "city": "FERNDALE",
            "state": "MI",
            "postal_code": "482202065",
            "telephone_number": "248-514-4955"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3535 W 13 Mile Rd Ste 140",
            "address_purpose": "LOCATION",
            "city": "Royal Oak",
            "state": "MI",
            "postal_code": "480736770",
            "country_code": "US",
            "telephone_number": "248-551-3000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3601 W 13 Mile Rd",
            "address_purpose": "LOCATION",
            "city": "Royal Oak",
            "state": "MI",
            "postal_code": "480736712",
            "country_code": "US",
            "telephone_number": "248-551-3000",
            "fax_number": "248-551-2426",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MULL",
        "first_name": "ALYSSA",
        "middle_name": "SUZANNE",
        "name_prefix": "Ms.",
        "credential": "CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-10-05",
        "last_updated": "2025-10-14",
        "certification_date": "2025-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MI",
            "license": "4704232789",
            "primary": true
        },
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "MI",
            "license": "4704232789",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "amull441312@direct.beaumont.edu",
            "affiliation": "N",
            "address_1": "3601 W 13 Mile Rd",
            "city": "Royal Oak",
            "state": "MI",
            "country_code": "US",
            "postal_code": "480736712",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Ferndale, MI

Sources for this page

Verify at the official NPI Registry.