Individual provider Active NPI

Nancy Hammoudah, PHD

  • Psychologist
  • Livonia, MI
National Provider Identifier
1083274773
Registry record updated Jan 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
6351000927 Issued in MI
Practice address
17940 Farmington Rd Ste 302
Livonia, MI 48152-3159
Phone
(800) 693-1916
Fax
(248) 605-3525
NPI assigned
Jun 16, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 13, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 6351000927 MI Primary

Addresses

Primary practice location

17940 Farmington Rd Ste 302
Livonia, MI 48152-3159

Mailing address

PO Box 772263
Detroit, MI 48277-2263
Phone (800) 693-1916

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2017
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

28175 Haggerty Rd
Novi, MI 48377-2903

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
6351000927MIMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Richard Kneip, PH.D., P.C. CurrentSince Dec 1, 2021 Accepting new patients
Futures Healthcore, LLC Psychologist PastSince Jul 25, 2019 Accepting new patients

Locations

17940 Farmington Rd
Ste 302
Livonia, MI 48152
Phone (248) 219-5341

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1560643200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642032000000",
    "number": "1083274773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 772263",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482772263",
            "telephone_number": "800-693-1916",
            "fax_number": "248-605-3525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17940 FARMINGTON RD STE 302",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481523159",
            "telephone_number": "800-693-1916",
            "fax_number": "248-605-3525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAMMOUDAH",
        "first_name": "NANCY",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-06-16",
        "last_updated": "2022-01-13",
        "certification_date": "2022-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MI",
            "license": "6351000927",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Livonia, MI

Sources for this page

Verify at the official NPI Registry.