Individual provider Active NPI

Mya Patrice Ndiaye

  • Mental Health Counselor
  • Eastpointe, MI
National Provider Identifier
1467702407
Registry record updated Apr 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
6301015244 Issued in MI
Practice address
24420 Gratiot Ave
Eastpointe, MI 48021-3307
Phone
(313) 414-1945
Fax
(586) 944-2731
NPI assigned
Sep 18, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 3, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 6301015244 MI
Behavior Analyst 103K00000X 1-17-25043 MI
Mental Health Counselor 101YM0800X 6301015244 MI Primary

Addresses

Primary practice location

24420 Gratiot Ave
Eastpointe, MI 48021-3307

Mailing address

24420 Gratiot Ave
Eastpointe, MI 48021-3307
Phone (313) 414-1945

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Care Compare profile

Medicare Care Compare
Specialty
Undefined Non-Physician Type (Specify)
Education
Other, 2012
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

24420 Gratiot Ave
Eastpointe, MI 48021-3396

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6301015244MIMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Open Door Living Services, LLC Behavior Analyst Current Accepting new patients
Open Door Family Center, LLC Past Accepting new patients

Locations

24420 Gratiot Ave
Eastpointe, MI 48021
Phone (586) 218-8570

Organizations & group practices 2

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": "1347926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775174400000",
    "number": "1467702407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24420 GRATIOT AVE",
            "city": "EASTPOINTE",
            "state": "MI",
            "postal_code": "480213307",
            "telephone_number": "313-414-1945",
            "fax_number": "586-944-2731"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24420 GRATIOT AVE",
            "city": "EASTPOINTE",
            "state": "MI",
            "postal_code": "480213307",
            "telephone_number": "313-414-1945",
            "fax_number": "586-944-2731"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NDIAYE",
        "first_name": "MYA",
        "middle_name": "PATRICE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-09-18",
        "last_updated": "2026-04-03",
        "certification_date": "2026-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6301015244",
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "MI",
            "license": "1-17-25043",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MI",
            "license": "6301015244",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eastpointe, MI

Sources for this page

Verify at the official NPI Registry.