Individual provider Active NPI

Melissa Beth Oleshansky, PH.D.

  • Clinical Psychologist
  • Waterford, MI
National Provider Identifier
1396870135
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
6301012612 Issued in MI
Practice address
1473 Kessler Ave
Waterford, MI 48328-4754
Phone
(248) 682-5757
Fax
(248) 682-4480
NPI assigned
Feb 22, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

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 6301012612 MI Primary

Addresses

Primary practice location

1473 Kessler Ave
Waterford, MI 48328-4754

Mailing address

1473 Kessler Ave
Waterford, MI 48328-4754
Phone (248) 682-5757

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
I20050301000576 MI Practitioner - Clinical Psychologist 2163475245 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Joel L Young MD PCGroup PAC ID 3971575929, 59 clinicians

Practice addresses (Care Compare)

441 S Livernois Rd
Rochester Hills, MI 48307-2585
Phone (248) 608-8800

441 S Livernois Rd
Suite 100
Rochester Hills, MI 48307-2586

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
6301012612MIMDClinical Psychologist

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": "1172102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1396870135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1473 KESSLER AVE",
            "city": "WATERFORD",
            "state": "MI",
            "postal_code": "483284754",
            "telephone_number": "248-682-5757",
            "fax_number": "248-682-4480"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1473 KESSLER AVE",
            "city": "WATERFORD",
            "state": "MI",
            "postal_code": "483284754",
            "telephone_number": "248-682-5757",
            "fax_number": "248-682-4480"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLESHANSKY",
        "first_name": "MELISSA",
        "middle_name": "BETH",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6301012612",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waterford, MI

Sources for this page

Verify at the official NPI Registry.