Individual provider Active NPI

Gerda T Mah, MA LLP

  • Clinical Psychologist
  • Troy, MI
National Provider Identifier
1386754117
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
6301000810 Issued in MI
Practice address
888 W Big Beaver Rd
1450
Troy, MI 48084-4736
Phone
(248) 244-8644
Fax
(248) 244-1330
NPI assigned
Aug 30, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 6301000810 MI Primary

Addresses

Primary practice location

888 W Big Beaver Rd
1450
Troy, MI 48084-4736

Mailing address

2958 Orbit Dr
Lake Orion, MI 48360-1976
Phone (248) 391-2043

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
6301000810MIMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1386754117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2958 ORBIT DR",
            "city": "LAKE ORION",
            "state": "MI",
            "postal_code": "483601976",
            "telephone_number": "248-391-2043",
            "fax_number": "248-391-0890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "888 W BIG BEAVER RD",
            "address_2": "1450",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480844736",
            "telephone_number": "248-244-8644",
            "fax_number": "248-244-1330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAH",
        "first_name": "GERDA",
        "middle_name": "T",
        "name_prefix": "Ms.",
        "credential": "MA LLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6301000810",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Troy, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.