Katrina Ivory, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

4704377051 Issued in MI

Practice address

11000 W McNichols Rd Ste 3231029
Detroit, MI 48221-2357

Phone

(313) 649-5188

NPI assigned

Jan 30, 2026

Last updated

Mar 11, 2026By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2025

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Mindshift & Wellness PLLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Southfield, MI
  • NPI 1598692089
  Medicare reassignment NPD (past) Authorized official
• Mindshift & Wellness LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Sylvania, OH
  • NPI 1801735667
  NPD

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

{
    "created_epoch": "1769731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773187200000",
    "number": "1063362853",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11000 W MCNICHOLS RD STE 3231029",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482212357",
            "telephone_number": "313-649-5188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11000 W MCNICHOLS RD STE 3231029",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482212357",
            "telephone_number": "313-649-5188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IVORY",
        "first_name": "KATRINA",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-01-30",
        "last_updated": "2026-03-11",
        "certification_date": "2026-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MI",
            "license": "4704377051",
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OH",
            "license": "0041323",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Blessing Imade Itua, M.D
• Bianca Estela Ituarte, MD
• Katrina Iverson, MD
• Sonia Denise Iverson
• Shalondia Aletia Ivey
• Lakisha Reshaun Ivory
• Linda Ivory
• Monique Ivory, ND
• Jimmy Ivy
• Hirotaka Iwaki

• Psychiatric/Mental Health Nurse Practitioner in Detroit, MI
• Providers in Detroit, MI by specialty
• Psychiatric/Mental Health Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.