Individual provider Active NPI

Ashlee Jean Mosley, M.S., T.L.L.P.

  • Psychologist
  • Wayne, MI
National Provider Identifier
1477816510
Registry record updated Jun 22, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
6301014996 Issued in MI
Practice address
35640 W Michigan Ave
Wayne, MI 48184-1628
Phone
(734) 626-7615
NPI assigned
Jun 22, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 6301014996 MI Primary

Addresses

Primary practice location

35640 W Michigan Ave
Wayne, MI 48184-1628

Mailing address

35640 W Michigan Ave
Wayne, MI 48184-1628
Phone (734) 626-7615

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)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
6301014996MIMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Michigan Modern Psychology Group,PLLC CurrentSince Jun 29, 2024 Accepting new patients

Locations

835 Mason St
Ste B220
Dearborn, MI 48124
Phone 3135619064 ext. 102

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": "1340323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1340323200000",
    "number": "1477816510",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35640 W MICHIGAN AVE",
            "city": "WAYNE",
            "state": "MI",
            "postal_code": "481841628",
            "telephone_number": "734-626-7615"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35640 W MICHIGAN AVE",
            "city": "WAYNE",
            "state": "MI",
            "postal_code": "481841628",
            "telephone_number": "734-626-7615"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOSLEY",
        "first_name": "ASHLEE",
        "middle_name": "JEAN",
        "name_prefix": "Ms.",
        "credential": "M.S., T.L.L.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-22",
        "last_updated": "2012-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MI",
            "license": "6301014996",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wayne, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.