Susan Rebecca Malott

Primary specialty

Adult Psychiatric/Mental Health Registered NurseTaxonomy code 163WP0809X

License

4704180080 Issued in MI

Practice address

1410 S Telegraph Rd
Bloomfield Hills, MI 48302-0046

Phone

(248) 456-8153

NPI assigned

Jun 14, 2017

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1497398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1497398400000",
    "number": "1053841825",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1410 S TELEGRAPH RD",
            "city": "BLOOMFIELD HILLS",
            "state": "MI",
            "postal_code": "48302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1410 S TELEGRAPH RD",
            "city": "BLOOMFIELD HILLS",
            "state": "MI",
            "postal_code": "483020046",
            "telephone_number": "248-456-8153"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALOTT",
        "first_name": "SUSAN",
        "middle_name": "REBECCA",
        "name_prefix": "Ms.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-06-14",
        "last_updated": "2017-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0809X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health, Adult",
            "state": "MI",
            "license": "4704180080",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Erik Joseph Makie, PSY.D.
• Making It Matter Counseling, PLLC
• Sandra Lynn Makram, D.D.S.
• Rebecca Ann Malcolm, PTA
• Twyla Malcom, LPC
• Callie Manasco
• Minal Ashish Manek
• Julie Manning, PSY MALLP
• Violet Kim Manning
• George Nazar Mansoor

• Adult Psychiatric/Mental Health Registered Nurse in Bloomfield Hills, MI
• Providers in Bloomfield Hills, MI by specialty
• Adult Psychiatric/Mental Health Registered Nurse in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2017; 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.