Mustapha Mouawia

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

6351004683 Issued in MI

Practice address

4794 Rosalie St
Dearborn, MI 48126-2829

Phone

(313) 423-5878

NPI assigned

Feb 19, 2024

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Dr. Mustapha Mouawia Former name

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

Specialty

Clinical Psychologist

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Safe Wellness Center PLLCGroup PAC ID 0749727485, 6 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

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.

• Safe Wellness Center PLLC

  • Internal Medicine Physician
  • Dearborn, MI
  • NPI 1538847249
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1708300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708300800000",
    "number": "1558126540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4794 ROSALIE ST",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481262829",
            "telephone_number": "313-423-5878"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4794 ROSALIE ST",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481262829",
            "telephone_number": "313-423-5878"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13320 W Warren Ave",
            "address_purpose": "LOCATION",
            "city": "Dearborn",
            "state": "MI",
            "postal_code": "481261417",
            "country_code": "US",
            "telephone_number": "313-423-5878",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "23302 W Warren St",
            "address_purpose": "LOCATION",
            "city": "Dearborn Heights",
            "state": "MI",
            "postal_code": "481272493",
            "country_code": "US",
            "telephone_number": "313-423-5878",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOUAWIA",
        "first_name": "MUSTAPHA",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-02-19",
        "last_updated": "2024-02-19",
        "certification_date": "2024-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": "MI",
            "license": "6362009851",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6351004683",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MUSTAPHA",
            "last_name": "MOUAWIA",
            "prefix": "DR.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Clinical Psychologist in Dearborn, MI
• Providers in Dearborn, MI by specialty
• Clinical Psychologist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.