Individual provider Active NPI

Maria T Aretakis, PHD

  • Clinical Child & Adolescent Psychologist
  • Ann Arbor, MI
National Provider Identifier
1235321324
Registry record updated Dec 19, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Child & Adolescent PsychologistTaxonomy code 103TC2200X
Practice address
530 Church St
Ann Arbor, MI 48109-1043
Phone
(734) 764-3471
NPI assigned
Aug 14, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X
Clinical Child & Adolescent Psychologist 103TC2200X Primary

Addresses

Primary practice location

530 Church St
Ann Arbor, MI 48109-1043

Mailing address

530 Church St
Ann Arbor, MI 48109-1043
Phone (734) 764-3471

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190109002083 MI Practitioner - Clinical Psychologist 0648516872 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hamilton Wellness PLCGroup PAC ID 6901130459, 5 clinicians

Practice addresses (Care Compare)

16931 19 Mile Rd
Suite 140
Clinton Township, MI 48038-4841
Phone (586) 226-2822

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

Practice roles

OrganizationSpecialtyStatusNew patients
Hamilton Wellness, PLC CurrentSince May 1, 2019 Accepting new patients

Locations

16931 19 Mile Rd
Ste 140
Clinton Twp, MI 48038
Phone (586) 226-2822

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1187049600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1418947200000",
    "number": "1235321324",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "530 CHURCH ST",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481091043",
            "telephone_number": "734-764-3471"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "530 CHURCH ST",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481091043",
            "telephone_number": "734-764-3471"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ARETAKIS",
        "first_name": "MARIA",
        "middle_name": "T",
        "name_prefix": "Ms.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-14",
        "last_updated": "2014-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ann Arbor, MI

Sources for this page

Verify at the official NPI Registry.