Active NPI
Muna Mashrah, TLLP
- Clinical Psychologist
- Detroit, MI
National Provider Identifier
1457789109
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 6301015733
- Practice address
- 62 W 7 Mile Rd
Detroit, MI 48203-1967 - Phone
- (313) 893-6172
- NPI assigned
- Oct 16, 2013
- Sex
- Female
- 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 | 6301015733 | MI | Primary |
Addresses
Primary practice location
62 W 7 Mile Rd
Detroit, MI 48203-1967
Mailing address
4725 Orchard Ave
Dearborn, MI 48126-4600
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3434247 | Medicaid | MI |
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 |
|---|---|---|---|
| 6301015733 | MI | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1381881600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1381881600000",
"number": "1457789109",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4725 ORCHARD AVE",
"city": "DEARBORN",
"state": "MI",
"postal_code": "481264600"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "62 W 7 MILE RD",
"city": "DETROIT",
"state": "MI",
"postal_code": "482031967",
"telephone_number": "313-893-6172"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MASHRAH",
"first_name": "MUNA",
"credential": "TLLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-10-16",
"last_updated": "2013-10-16",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "MI",
"license": "6301015733",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3434247",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Detroit, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.