Individual provider Active NPI

Mfon Essien

  • Psychiatric/Mental Health Nurse Practitioner
  • West Bloomfield, MI
National Provider Identifier
1275276750
Registry record updated Nov 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
4704282328 Issued in MI
Practice address
4856 Teddington Dr
West Bloomfield, MI 48323-2666
Phone
(248) 660-2339
NPI assigned
Apr 14, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 4704282328 MI Primary

Addresses

Primary practice location

4856 Teddington Dr
West Bloomfield, MI 48323-2666

Mailing address

4856 Teddington Dr
West Bloomfield, MI 48323-2666

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: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220826001772 MI Practitioner - Nurse Practitioner 7911381868 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Downriver Mental Health Clinic PCGroup PAC ID 7911995139, 289 clinicians

Practice addresses (Care Compare)

2200 Genoa Business Park Dr
Suite 100
Brighton, MI 48114-5328
Phone (810) 494-7180

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Grow Healthcare Group PA Psychiatric/Mental Health CurrentSince Jan 9, 2024 Accepting new patients
Downriver Mental Health Clinic PC CurrentSince Aug 11, 2022 Accepting new patients
Downriver Mental Health Clinic PC CurrentSince Aug 11, 2022 Accepting new patients

Locations

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

2200 Genoa Business Park Dr
Ste 100
Brighton, MI 48114
Phone (810) 449-7180

1400 Abbot Rd
Ste 400
East Lansing, MI 48823
Phone (810) 220-2787

250 Monroe Ave NW
Ste 400
Grand Rapids, MI 49503
Phone (616) 441-4616

20500 Eureka Rd
Ste 200
Taylor, MI 48180
Phone (734) 285-8282

Interoperability endpoints

  • Direct secure messaging: lifestancehealth.mfonessien@150339.advancedmd-direct.com

Organizations & group practices 3

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": "1649894400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667433600000",
    "number": "1275276750",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4856 TEDDINGTON DR",
            "city": "WEST BLOOMFIELD",
            "state": "MI",
            "postal_code": "483232666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4856 TEDDINGTON DR",
            "city": "WEST BLOOMFIELD",
            "state": "MI",
            "postal_code": "483232666",
            "telephone_number": "248-660-2339"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ESSIEN",
        "first_name": "MFON",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-04-14",
        "last_updated": "2022-11-03",
        "certification_date": "2022-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MI",
            "license": "4704282328",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Bloomfield, MI

Sources for this page

Verify at the official NPI Registry.