Mylah Terese Ivory, LMSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6801065011 Issued in MI

Practice address

2080 Whittaker Rd Ste 164
Ypsilanti, MI 48197-8238

Phone

(734) 612-7991

NPI assigned

May 14, 2013

Last updated

Jul 16, 2021By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

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 Social Worker

Education

Other, 1992

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• M & M Mind and Body Therapy

  • Clinical Social Worker
  • Ypsilanti, MI
  • NPI 1780256834
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1368489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626393600000",
    "number": "1619313947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2080 WHITTAKER RD STE 164",
            "city": "YPSILANTI",
            "state": "MI",
            "postal_code": "481978238",
            "telephone_number": "734-612-7991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2080 WHITTAKER RD STE 164",
            "city": "YPSILANTI",
            "state": "MI",
            "postal_code": "481978238",
            "telephone_number": "734-612-7991"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IVORY",
        "first_name": "MYLAH",
        "middle_name": "TERESE",
        "name_prefix": "Mrs.",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-05-14",
        "last_updated": "2021-07-16",
        "certification_date": "2021-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801065011",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Thamina Ali Issa, AGACNP-BC
• Ahmad Issawi, M.D.
• Mahmoud Isseh, MD
• Judith Ann Ivacko, M.D.
• Ivf Michigan, P.C.
• Paul Herbert Izenberg, M.D.
• Emilohi Izirein
• J3L Care Transportation LLC
• Alexes Jackson
• Audrey Lee Jackson, MSW

• Clinical Social Worker in Ypsilanti, MI
• Providers in Ypsilanti, MI by specialty
• Clinical Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2021; 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.