NPIMap

Organization Active NPI

Kindmind Psychiatric Health

  • Psychiatry Physician
  • Clarkston, MI
National Provider Identifier
1093409666
Registry record updated Jun 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
KINDMIND PSYCHIATRIC HEALTH
Practice address
5980 S Main St Ste 101
Clarkston, MI 48346-2377
Phone
(248) 470-7359
NPI assigned
Jun 6, 2023
Last updated
Jun 6, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2023

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

Authorized official

Name
Michael Nadhir
Title
Chief Executive Officer
Phone
(248) 470-7359

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X Primary

Addresses

Primary practice location

5980 S Main St Ste 101
Clarkston, MI 48346-2377

Mailing address

3000 Interlaken St
West Bloomfield, MI 48323-1820
Phone (248) 470-7359

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20241211003474 MI Part B Supplier - Clinic/Group Practice 3577099787 Receives reassigned benefits from 3 practitioners
Practice locations: Clarkston, MI; Rochester, MI

National Provider Directory

National Provider Directory

Locations

5980 S Main St
Ste 101
Clarkston, MI 48346
Phone (248) 266-0920

Practitioners & affiliated clinicians

Practitioners 26

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 26

NPI Registry JSON

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

{
    "created_epoch": "1686009600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1686009600000",
    "number": "1093409666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3000 INTERLAKEN ST",
            "city": "WEST BLOOMFIELD",
            "state": "MI",
            "postal_code": "483231820",
            "telephone_number": "248-470-7359"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5980 S MAIN ST STE 101",
            "city": "CLARKSTON",
            "state": "MI",
            "postal_code": "483462377",
            "telephone_number": "248-470-7359"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KINDMIND PSYCHIATRIC HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-06-06",
        "last_updated": "2023-06-06",
        "certification_date": "2023-06-06",
        "status": "A",
        "authorized_official_last_name": "NADHIR",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "248-470-7359"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clarkston, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.