Active NPI
Assaad Khreiss
- Adult Development & Aging Psychologist
- Dearborn, MI
National Provider Identifier
1396616900
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Development & Aging Psychologist
- License
- 994288612
- Practice address
- 3800 Greenfield Rd
Dearborn, MI 48120-1206 - Phone
- (313) 455-0045
- NPI assigned
- Sep 16, 2025
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Development & Aging Psychologist | 103TA0700X | 994288612 | MI | Primary |
Addresses
Primary practice location
3800 Greenfield Rd
Dearborn, MI 48120-1206
Mailing address
3800 Greenfield Rd
Dearborn, MI 48120-1206
Phone (313) 455-0045
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
| License | State | Type | Specialty |
|---|---|---|---|
| 994288612 | MI | MD | Adult Development & Aging Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1757980800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1757980800000",
"number": "1396616900",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3800 GREENFIELD RD",
"city": "DEARBORN",
"state": "MI",
"postal_code": "481201206",
"telephone_number": "313-455-0045"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3800 GREENFIELD RD",
"city": "DEARBORN",
"state": "MI",
"postal_code": "481201206",
"telephone_number": "313-455-0045"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KHREISS",
"first_name": "ASSAAD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2025-09-16",
"last_updated": "2025-09-16",
"certification_date": "2025-09-16",
"status": "A"
},
"taxonomies": [
{
"code": "103TA0700X",
"taxonomy_group": "",
"desc": "Psychologist, Adult Development & Aging",
"state": "MI",
"license": "994288612",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dearborn, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.