Drew Melesky, MA, TLLP

Primary specialty

School PsychologistTaxonomy code 103TS0200X

License

SP0000001035969 Issued in MI

Practice address

4160 Woodward Ave FL 2
Detroit, MI 48201-2027

Phone

(313) 656-4052

NPI assigned

Jul 1, 2021

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

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 and National Provider Directory roles.

• Imagine Center LLC

  • Clinical Psychologist
  • Northville, MI
  • NPI 1467899666
  NPD

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

{
    "created_epoch": "1625097600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625097600000",
    "number": "1619547585",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30346 SOUTHFIELD RD",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480761353",
            "telephone_number": "586-201-4127"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4160 WOODWARD AVE FL 2",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482012027",
            "telephone_number": "313-656-4052"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MELESKY",
        "first_name": "DREW",
        "credential": "MA, TLLP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-07-01",
        "last_updated": "2021-07-01",
        "certification_date": "2021-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6362009321",
            "primary": false
        },
        {
            "code": "103TS0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, School",
            "state": "MI",
            "license": "SP0000001035969",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tariq A Mekkaoui, DO
• Mel Bornstein Clinic of Detroit
• Jaclyn Emma Melasi, GC
• Ashley Elizabeth Melchor, LLMSW
• Maritza Melendez
• Michael Rony Melhem, MD
• Meljoys Human Services , Inc
• Antoine Elie Melkane, M.D.
• Suzanne M Mell, CRNA
• Trevor James Mell

• School Psychologist in Detroit, MI
• Providers in Detroit, MI by specialty
• School Psychologist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2021; 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.