NPIMap

Organization Active NPI

Nexus Behavioral Health PLLC

  • Clinical Psychologist
  • Troy, MI
National Provider Identifier
1477066140
Registry record updated Nov 15, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
Legal business name
NEXUS BEHAVIORAL HEALTH PLLC
Practice address
3334 Rochester Rd # 205
Troy, MI 48083-5426
Phone
(843) 450-8611
NPI assigned
Nov 15, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2017

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

Authorized official

Name
Dr. Matthew Kadrich, PSY.D., LPNPI 1649782244
Title
President
Phone
(843) 450-8611

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical NeuropsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103G00000X
Clinical PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC0700X Primary
Adolescent and Children Mental Health Clinic/Center 261QM0855X

Addresses

Primary practice location

3334 Rochester Rd # 205
Troy, MI 48083-5426

Mailing address

3334 Rochester Rd # 205
Troy, MI 48083-5426

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180123002075 MI Part B Supplier - Clinic/Group Practice 1052670965 Receives reassigned benefits from 7 practitioners
Practice locations: Troy, MI

National Provider Directory

National Provider Directory

Locations

363 W Big Beaver Rd
Ste 400
Troy, MI 48084
Phone (248) 509-7657

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1510704000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1510704000000",
    "number": "1477066140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3334 ROCHESTER RD # 205",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480835426"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3334 ROCHESTER RD # 205",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480835426",
            "telephone_number": "843-450-8611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEXUS BEHAVIORAL HEALTH PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-11-15",
        "last_updated": "2017-11-15",
        "status": "A",
        "authorized_official_last_name": "KADRICH",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "843-450-8611",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSY.D., LP"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Clinical Neuropsychologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Troy, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.