Individual provider Active NPI

Munira Musslih Kassim

  • Clinical Psychologist
  • Detroit, MI
National Provider Identifier
1386914745
Registry record updated Jan 3, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
6301014946 Issued in MI
Practice address
16921 W Warren Ave
Detroit, MI 48228-3504
Phone
(313) 581-7287
NPI assigned
Jan 3, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2012

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 6301014946 MI Primary

Addresses

Primary practice location

16921 W Warren Ave
Detroit, MI 48228-3504

Mailing address

16921 W Warren Ave
Detroit, MI 48228-3504
Phone (313) 581-7287

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

State licenses

LicenseStateTypeSpecialty
6301014946MIMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1325548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1325548800000",
    "number": "1386914745",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16921 W WARREN AVE",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482283504",
            "telephone_number": "313-581-7287"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16921 W WARREN AVE",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482283504",
            "telephone_number": "313-581-7287"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KASSIM",
        "first_name": "MUNIRA",
        "middle_name": "MUSSLIH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-01-03",
        "last_updated": "2012-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6301014946",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2012; 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.