Individual provider Active NPI

Alisa Marie Hilewsky, PSYD, LP, LPC

  • Psychologist
  • Warren, MI
National Provider Identifier
1407002447
Registry record updated Dec 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
6301013924 Issued in MI
Practice address
31201 Chicago Rd S Ste A201
Warren, MI 48093-5552
Phone
(248) 543-0033
Fax
(248) 548-5309
NPI assigned
Aug 11, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 12, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 6301013924 MI Primary

Addresses

Primary practice location

31201 Chicago Rd S Ste A201
Warren, MI 48093-5552

Mailing address

31201 Chicago Rd S Ste A201
Warren, MI 48093-5552
Phone (248) 543-0033

Other practice location 1

64541 Van Dyke Rd Ste 101B
Washington Twp, MI 48095-2570
Phone (248) 543-0033

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
I20161228000444 MI Practitioner - Clinical Psychologist 3072737337 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
The Mindful Self LLCGroup PAC ID 1456575711, 7 clinicians

Practice addresses (Care Compare)

31201 Chicago Rd S
Suite A201
Warren, MI 48093-5552
Phone (248) 543-0033

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6301013924MIMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
The Mindful Self, LLC Psychologist CurrentSince Dec 1, 2016 Accepting new patients

Locations

28303 Dequindre Rd
Ste 200
Madison Heights, MI 48071
Phone (248) 543-0033

31201 Chicago Rd S
Ste A201
Warren, MI 48093
Phone (248) 543-0033

64541 Van Dyke Rd
Ste 101B
Washington Twp, MI 48095
Phone (248) 543-0033

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1218412800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733961600000",
    "number": "1407002447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31201 CHICAGO RD S STE A201",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480935552",
            "telephone_number": "248-543-0033",
            "fax_number": "248-548-5309"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31201 CHICAGO RD S STE A201",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480935552",
            "telephone_number": "248-543-0033",
            "fax_number": "248-548-5309"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "64541 Van Dyke Rd Ste 101B",
            "address_purpose": "LOCATION",
            "city": "Washington Twp",
            "state": "MI",
            "postal_code": "480952570",
            "country_code": "US",
            "telephone_number": "248-543-0033",
            "fax_number": "248-548-5309",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HILEWSKY",
        "first_name": "ALISA",
        "middle_name": "MARIE",
        "credential": "PSYD, LP, LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-08-11",
        "last_updated": "2024-12-12",
        "certification_date": "2024-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MI",
            "license": "6301013924",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Warren, MI

Sources for this page

Verify at the official NPI Registry.