Dr Michelle L Iyamah Psychodiagnostics LLC

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

DR MICHELLE L IYAMAH PSYCHODIAGNOSTICS LLC

Practice address

933 N Mayfair Rd Ste 101
Wauwatosa, WI 53226-3432

Phone

(414) 551-4773

NPI assigned

Aug 9, 2018

Organization subpart

No

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

Authorized official

Name

Mrs. Pascal Sharmilee

Title

Medical Biller

Phone

(262) 432-0919

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1533772800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1533772800000",
    "number": "1336628346",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "933 N MAYFAIR RD STE 101",
            "city": "WAUWATOSA",
            "state": "WI",
            "postal_code": "532263432",
            "telephone_number": "414-551-4773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "933 N MAYFAIR RD STE 101",
            "city": "WAUWATOSA",
            "state": "WI",
            "postal_code": "532263432",
            "telephone_number": "414-551-4773"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR MICHELLE L IYAMAH PSYCHODIAGNOSTICS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-08-09",
        "last_updated": "2018-08-09",
        "status": "A",
        "authorized_official_last_name": "SHARMILEE",
        "authorized_official_first_name": "PASCAL",
        "authorized_official_title_or_position": "MEDICAL BILLER",
        "authorized_official_telephone_number": "262-432-0919",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100004821",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Clinic/Center (Including Community Mental Health Center) in Wauwatosa, WI
• Providers in Wauwatosa, WI by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2018; 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.