Northwestern Psychiatry & Counseling Center PC

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

MM048520 Issued in MI

Legal business name

NORTHWESTERN PSYCHIATRY & COUNSELING CENTER PC

Practice address

26699 W 12 Mile Rd Ste 100
Southfield, MI 48034-1578

Phone

(248) 945-9370

Fax

(248) 945-9377

NPI assigned

Feb 2, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Madhu Mendiratta, MDNPI 1467447441

Title

MD

Phone

(248) 945-9370

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Locations

Practitioners 1

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

• Madhu Mendiratta, MD

  • Psychiatry Physician
  • Southfield, MI
  • NPI 1467447441
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1170374400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1404086400000",
    "number": "1275671968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26699 W 12 MILE RD STE 100",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480341578",
            "telephone_number": "248-945-9370",
            "fax_number": "248-945-9377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26699 W 12 MILE RD STE 100",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480341578",
            "telephone_number": "248-945-9370",
            "fax_number": "248-945-9377"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHWESTERN PSYCHIATRY & COUNSELING CENTER PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-02",
        "last_updated": "2014-06-30",
        "status": "A",
        "authorized_official_last_name": "MENDIRATTA",
        "authorized_official_first_name": "MADHU",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "248-945-9370",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MI",
            "license": "MM048520",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBCM",
            "identifier": "2606351352",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Psychiatry Physician in Southfield, MI
• Providers in Southfield, 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 30, 2014; 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.