Active NPI
Michael Robert Nadorff, PHD
- Clinical Psychologist
- Mississippi State, MS
National Provider Identifier
1417522616
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 54942
- Practice address
- 223 Famous Maroon Band Street
Mississippi State, MS 39762 - Phone
- (662) 325-0621
- NPI assigned
- May 21, 2021
- 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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 54942 | MS | Primary |
Addresses
Primary practice location
223 Famous Maroon Band Street
Mississippi State, MS 39762
Mailing address
PO Box 6124
Mississippi State, MS 39762
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
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 54942 | MS | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mississippi State University | Clinical | Current | Accepting new patients |
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.
-
dba MSU Behavioral Health
- Mental Health Counselor
- Mississippi State, MS
- NPI 1518747567
Clinical
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1621555200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1740528000000",
"number": "1417522616",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 6124",
"city": "MISSISSIPPI STATE",
"state": "MS",
"postal_code": "39762"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "223 FAMOUS MAROON BAND STREET",
"city": "MISSISSIPPI STATE",
"state": "MS",
"postal_code": "39762",
"telephone_number": "662-325-0621"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NADORFF",
"first_name": "MICHAEL",
"middle_name": "ROBERT",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-05-21",
"last_updated": "2025-02-26",
"certification_date": "2021-05-04",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "MS",
"license": "54942",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mississippi State, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 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.