Individual provider Active NPI

Jeannah Rose Oxford Abou Assaly

  • Psychologist
  • Ann Arbor, MI
National Provider Identifier
1174483515
Registry record updated Dec 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
6362010093 Issued in MI
Practice address
2000 Hogback Rd Ste 2
Ann Arbor, MI 48105-9735
Phone
(734) 386-0041
NPI assigned
Nov 17, 2025
Last updated
Dec 17, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 6362010093 MI Primary

Addresses

Primary practice location

2000 Hogback Rd Ste 2
Ann Arbor, MI 48105-9735

Mailing address

653 Duchess St
Milford, MI 48381-1101
Phone (248) 202-4478

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
6362010093MIMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Complete Neuropsychology Services, Inc Psychologist CurrentSince Nov 24, 2025 Accepting new patients

Locations

2000 Hogback Rd
Ste 2
Ann Arbor, MI 48105
Phone (734) 386-0041

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": "1763337600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765929600000",
    "number": "1174483515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "653 DUCHESS ST",
            "city": "MILFORD",
            "state": "MI",
            "postal_code": "483811101",
            "telephone_number": "248-202-4478"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 HOGBACK RD STE 2",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481059735",
            "telephone_number": "734-386-0041"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABOU ASSALY",
        "first_name": "JEANNAH ROSE",
        "middle_name": "OXFORD",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-11-17",
        "last_updated": "2025-12-17",
        "certification_date": "2025-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MI",
            "license": "6362010093",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ann Arbor, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2025; 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.