Individual provider Active NPI

Mona Makki

  • Clinical Psychologist
  • Bingham Farms, MI
National Provider Identifier
1396135026
Registry record updated Jun 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
6361005127 Issued in MI
Practice address
31700 Telegraph Rd
Bingham Farms, MI 48025-3407
Phone
(248) 220-4950
Fax
(855) 975-2420
NPI assigned
Feb 3, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 14, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
Clinical Psychologist 103TC0700X 6361005127 MI Primary

Addresses

Primary practice location

31700 Telegraph Rd
Bingham Farms, MI 48025-3407

Mailing address

31700 Telegraph Rd
Bingham Farms, MI 48025-3407
Phone (248) 220-4950

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
6361005127MIMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1422921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623628800000",
    "number": "1396135026",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31700 TELEGRAPH RD",
            "city": "BINGHAM FARMS",
            "state": "MI",
            "postal_code": "480253407",
            "telephone_number": "248-220-4950",
            "fax_number": "855-975-2420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31700 TELEGRAPH RD",
            "city": "BINGHAM FARMS",
            "state": "MI",
            "postal_code": "480253407",
            "telephone_number": "248-220-4950",
            "fax_number": "855-975-2420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAKKI",
        "first_name": "MONA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-02-03",
        "last_updated": "2021-06-14",
        "certification_date": "2021-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6361005127",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bingham Farms, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2021; 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.