Individual provider Active NPI

Mubeen Ejaz Qureshi

  • Clinical Social Worker
  • Sterling Heights, MI
National Provider Identifier
1164988903
Registry record updated Jul 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801110237 Issued in MI
Practice address
35053 Vito Dr
Sterling Heights, MI 48310-5043
Phone
(586) 207-7680
NPI assigned
Feb 18, 2019
Last updated
Jul 15, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 15, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 6801103839 MI
Clinical Social Worker 1041C0700X 6801110237 MI Primary

Addresses

Primary practice location

35053 Vito Dr
Sterling Heights, MI 48310-5043

Mailing address

35053 Vito Dr
Sterling Heights, MI 48310-5043
Phone (586) 207-7680

Other practice location 1

575 E Big Beaver Rd
Ste 210
Troy, MI 48083-1301
Phone (248) 515-8873

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
6801103839MIMDClinical Social Worker
6801110237MIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Mubeen Qureshi Therapy PLLC CurrentSince Jul 25, 2021 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1550448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626307200000",
    "number": "1164988903",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35053 VITO DR",
            "city": "STERLING HEIGHTS",
            "state": "MI",
            "postal_code": "483105043",
            "telephone_number": "586-207-7680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35053 VITO DR",
            "city": "STERLING HEIGHTS",
            "state": "MI",
            "postal_code": "483105043",
            "telephone_number": "586-207-7680"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "575 E Big Beaver Rd",
            "address_2": "STE 210",
            "address_purpose": "LOCATION",
            "city": "Troy",
            "state": "MI",
            "postal_code": "480831301",
            "country_code": "US",
            "telephone_number": "248-515-8873",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "QURESHI",
        "first_name": "MUBEEN",
        "middle_name": "EJAZ",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-02-18",
        "last_updated": "2021-07-15",
        "certification_date": "2021-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801103839",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801110237",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sterling Heights, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2021; 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.