Core Psych Livonia, PLC

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

Legal business name

CORE PSYCH LIVONIA, PLC

Practice address

17732 Farmington Rd
Livonia, MI 48152-3104

Phone

(586) 961-6420

NPI assigned

Jun 28, 2024

Organization subpart

No

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

Authorized official

Name

Dr. Shady Shebak, MDNPI 1629416169

Title

Psychiatrist

Phone

(586) 961-6420

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Locations

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Shady S Shebak, M.D.

  • Psychiatry Physician
  • Dearborn, MI
  • NPI 1629416169
  Medicare reassignment Care Compare group NPD Authorized official
• Tony Singh, DO

  • Psychiatry Physician
  • Detroit, MI
  • NPI 1467075515
  Medicare reassignment Care Compare group NPD
• Mariam Hussein Hachem, PA

  • Physician Assistant
  • Dearborn, MI
  • NPI 1356148423
  Medicare reassignment NPD
• Alexis Mrozinski, PA-C

  • Physician Assistant
  • Sterling Heights, MI
  • NPI 1649976846
  Medicare reassignment NPD
• Madison Michelle White, PA

  • Physician Assistant
  • Livonia, MI
  • NPI 1699500751
  Medicare reassignment NPD

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

{
    "created_epoch": "1719532800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1719532800000",
    "number": "1194560334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3815 PELHAM ST STE 13",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481243852",
            "telephone_number": "586-961-6420",
            "fax_number": "586-204-0211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17732 FARMINGTON RD",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481523104",
            "telephone_number": "586-961-6420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CORE PSYCH LIVONIA, PLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-06-28",
        "last_updated": "2024-06-28",
        "certification_date": "2024-06-20",
        "status": "A",
        "authorized_official_last_name": "SHEBAK",
        "authorized_official_first_name": "SHADY",
        "authorized_official_title_or_position": "PSYCHIATRIST",
        "authorized_official_telephone_number": "586-961-6420",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Morgan Copsey, COTA/L
• Annaliese Corace-Langbeen, LMSW-C
• Nicole Marie Cordero, MS, LLP
• Michael C Cordisco
• Brian M Cordovez, CCP
• Melissa Cork, FNP-C
• April N Cornell
• Keith Cornett
• Peter A Corrado, CCP
• Laura K. Corrigan, M.D.

• Psychiatry Physician in Livonia, MI
• Providers in Livonia, MI by specialty
• Psychiatry Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2024; 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.