Individual provider Active NPI

Mary Nicole Monahan

  • Clinical Psychologist
  • Royal Oak, MI
National Provider Identifier
1699251538
Registry record updated Jul 13, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
6301016983 Issued in MI
Practice address
221 S Main St Ste 201
Royal Oak, MI 48067-2653
Phone
(248) 398-6459
NPI assigned
Jul 13, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 13, 2018

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 6301016983 MI Primary

Addresses

Primary practice location

221 S Main St Ste 201
Royal Oak, MI 48067-2653

Mailing address

221 S Main St Ste 201
Royal Oak, MI 48067-2653
Phone (248) 398-6459

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
I20180730001127 MI Practitioner - Clinical Psychologist 8325396922 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
BCS of Michigan LLCGroup PAC ID 0840503652, 41 clinicians

Practice addresses (Care Compare)

28 S Prospect St
Villa at Park Ridge
Ypsilanti, MI 48198-5616
Phone (734) 483-2220

Merit-based Incentive Payment System (MIPS)

Final score
75.05 of 100Reported as group
Quality
0
Promoting interoperability
100
Improvement activities
40
Cost
83.49

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
6301016983MIMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
BCS of Michigan LLC Clinical CurrentSince Aug 28, 2023 Accepting new patients
Geriatric Psychiatric Services PLLC Clinical Past Accepting new patients

Locations

3265 122nd Ave
#R2
Allegan, MI 49010
Phone (269) 673-2102

39465 W 14 Mile Rd
Novi, MI 48377
Phone 24885939000

5500 Fort St
Trenton, MI 48183
Phone (734) 287-3000

28 S Prospect St
Ypsilanti, MI 48198
Phone (734) 483-2220

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1531440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1531440000000",
    "number": "1699251538",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "221 S MAIN ST STE 201",
            "city": "ROYAL OAK",
            "state": "MI",
            "postal_code": "480672653",
            "telephone_number": "248-398-6459"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "221 S MAIN ST STE 201",
            "city": "ROYAL OAK",
            "state": "MI",
            "postal_code": "480672653",
            "telephone_number": "248-398-6459"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONAHAN",
        "first_name": "MARY",
        "middle_name": "NICOLE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-07-13",
        "last_updated": "2018-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6301016983",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Royal Oak, MI

Sources for this page

Verify at the official NPI Registry.