Individual provider Active NPI

Brandy Spring Pass, MA. MFT

  • Marriage & Family Therapist
  • Detroit, MI
National Provider Identifier
1376788984
Registry record updated Mar 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
4101007284 Issued in MI
Practice address
882 Oakman Blvd
Detroit, MI 48238-3710
Phone
(313) 961-4890
NPI assigned
Dec 10, 2008
Last updated
Mar 4, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 4, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 4101007284 MI Primary

Addresses

Primary practice location

882 Oakman Blvd
Detroit, MI 48238-3710

Mailing address

882 Oakman Blvd
Detroit, MI 48238-3710
Phone (313) 961-4890

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
I20241218001173 MI Practitioner - Marriage and Family Therapist 0244767069 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4101007284MIMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Neighborhood Service Organization CurrentSince Oct 12, 2024 Accepting new patients

Locations

3426 Mack Ave
Detroit, MI 48207
Phone (313) 832-3100

8600 Woodward Ave
Detroit, MI 48202
Phone (313) 875-7601

35180 Nankin Blvd
Ste 205
Westland, MI 48185
Phone (313) 875-7601

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1228867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709510400000",
    "number": "1376788984",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "882 OAKMAN BLVD",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482383710",
            "telephone_number": "313-961-4890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "882 OAKMAN BLVD",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482383710",
            "telephone_number": "313-961-4890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PASS",
        "first_name": "BRANDY",
        "middle_name": "SPRING",
        "credential": "MA. MFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-12-10",
        "last_updated": "2024-03-04",
        "certification_date": "2024-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MI",
            "license": "4101007284",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

Verify at the official NPI Registry.