Prime Mental Health Staffing, LLC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

Legal business name

PRIME MENTAL HEALTH STAFFING, LLC

Practice address

15900 W 10 Mile Rd Ste 211
Southfield, MI 48075-2079

Phone

(734) 568-3024

Fax

(734) 527-6087

NPI assigned

Feb 27, 2023

Last updated

Feb 27, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Keisha Malone, NPNPI 1366177156

Title

Owner/Authorized Official

Phone

(734) 568-3024

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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.

• Keisha Diane Malone, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Redford, MI
  • NPI 1366177156
  NPD (past) Authorized official

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

{
    "created_epoch": "1677456000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1677456000000",
    "number": "1164121315",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15900 W 10 MILE RD STE 211",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480752079",
            "telephone_number": "734-568-3024",
            "fax_number": "734-527-6087"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15900 W 10 MILE RD STE 211",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480752079",
            "telephone_number": "734-568-3024",
            "fax_number": "734-527-6087"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIME MENTAL HEALTH STAFFING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-02-27",
        "last_updated": "2023-02-27",
        "certification_date": "2023-02-23",
        "status": "A",
        "authorized_official_last_name": "MALONE",
        "authorized_official_first_name": "KEISHA",
        "authorized_official_title_or_position": "OWNER/AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "734-568-3024",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Primesource of Michigan LLC
• Prince J Eubanks MD PC

• Psychiatric/Mental Health Nurse Practitioner in Southfield, MI
• Providers in Southfield, 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 Feb 27, 2023; 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.