Individual provider Active NPI

Sharon Jean Ridella-Mehlos, PH.D.

  • Clinical Psychologist
  • Monroe, MI
National Provider Identifier
1508923004
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
6301007808 Issued in MI
Practice address
22 W 2ND St
Monroe, MI 48161-2326
Phone
(734) 243-2316
NPI assigned
Jan 3, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 6301007808 MI Primary

Addresses

Primary practice location

22 W 2ND St
Monroe, MI 48161-2326

Mailing address

22 W 2ND St
Monroe, MI 48161-2326
Phone (734) 243-2316

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081107000043 MI Practitioner - Clinical Psychologist 3870652795 Practice locations: Monroe, MI

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

22 W 2ND St
Monroe, MI 48161-2326

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
6301007808MIMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Kris Karwowski Past Accepting new patients

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": "1167782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1508923004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 W 2ND ST",
            "city": "MONROE",
            "state": "MI",
            "postal_code": "481612326",
            "telephone_number": "734-243-2316"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 W 2ND ST",
            "city": "MONROE",
            "state": "MI",
            "postal_code": "481612326",
            "telephone_number": "734-243-2316"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIDELLA-MEHLOS",
        "first_name": "SHARON",
        "middle_name": "JEAN",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6301007808",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Monroe, MI

Sources for this page

Verify at the official NPI Registry.