Anitha Mummineni, M.S.,L.L.P.

Primary specialty

Intellectual & Developmental Disabilities PsychologistTaxonomy code 103TM1800X

License

6301012843 Issued in MI

Practice address

50889 Briar Ridge Lane
Northville, MI 48168-3215

Phone

(248) 276-8000

NPI assigned

Nov 6, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

Practice roles

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.

• Macomb Oakland Regional Center Inc.

  • Community/Behavioral Health Agency
  • Auburn Hills, MI
  • NPI 1023199965
  NPD (past)

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

{
    "created_epoch": "1257465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485993600000",
    "number": "1619204914",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50889 BRIAR RIDGE LN",
            "city": "NORTHVILLE",
            "state": "MI",
            "postal_code": "481686878"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50889 BRIAR RIDGE LANE",
            "city": "NORTHVILLE",
            "state": "MI",
            "postal_code": "481683215",
            "telephone_number": "248-276-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUMMINENI",
        "first_name": "ANITHA",
        "credential": "M.S.,L.L.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-11-06",
        "last_updated": "2017-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TM1800X",
            "taxonomy_group": "",
            "desc": "Psychologist, Intellectual & Developmental Disabilities",
            "state": "MI",
            "license": "6301012843",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kalyani T. Movva, M.D.
• Max Moylan, LLMSW - CLINICAL
• Katharine Malone Mudry, MSW
• Annette Zielke Mullett, M.D.
• Elisbeth Mullins
• Sarla Mundade
• Meghann Murphy, TLLP
• Marcy Martha Murrell, D.D.S.
• Adriana Myers, RBT
• Mary Ann Myler, FNP-BC

• Intellectual & Developmental Disabilities Psychologist in Northville, MI
• Providers in Northville, MI by specialty
• Intellectual & Developmental Disabilities Psychologist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2017; 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.