Individual provider Active NPI

Ghadeer Makki

  • Behavior Analyst
  • Walled Lake, MI
National Provider Identifier
1508453325
Registry record updated Apr 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
Practice address
1010 E West Maple Rd Ste 100
Walled Lake, MI 48390-3571
Phone
(248) 313-2900
NPI assigned
Dec 28, 2020
Last updated
Apr 17, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2024

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 6362009612 MI
Behavior Technician 106S00000X
Behavior Analyst 103K00000X Primary

Addresses

Primary practice location

1010 E West Maple Rd Ste 100
Walled Lake, MI 48390-3571

Mailing address

1401 Cambridge Dr
Dearborn, MI 48124-1732
Phone (313) 492-8978

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address pcerecords.essmichigan@direct.mihin.net Easter Seals - Michigan, Inc.

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

LicenseStateTypeSpecialty
6362009612MIMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Easterseals Morc Health Care, Inc. CurrentSince Oct 6, 2024 Accepting new patients
Easterseals Morc Health Care, Inc. PastSince Sep 4, 2022 Accepting new patients

Locations

2399 E Walton Blvd
Auburn Hills, MI 48326
Phone (248) 475-6400

1010 E West Maple Rd
Ste 100
Walled Lake, MI 48390
Phone (248) 313-2900

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1609113600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713312000000",
    "number": "1508453325",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 CAMBRIDGE DR",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481241732",
            "telephone_number": "313-492-8978"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 E WEST MAPLE RD STE 100",
            "city": "WALLED LAKE",
            "state": "MI",
            "postal_code": "483903571",
            "telephone_number": "248-313-2900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAKKI",
        "first_name": "GHADEER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-12-28",
        "last_updated": "2024-04-17",
        "certification_date": "2024-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6362009612",
            "primary": false
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "pcerecords.essmichigan@direct.mihin.net",
            "affiliation": "Y",
            "affiliationName": "Easter Seals - Michigan, Inc.",
            "address_1": "2399 E Walton Blvd",
            "city": "Auburn Hills",
            "state": "MI",
            "country_code": "US",
            "postal_code": "483261955",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Walled Lake, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2024; 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.