Active NPI
Reem Baha Fakherddine, MA TLLP
- Clinical Psychologist
- Westland, MI
National Provider Identifier
1700426699
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 6301018111
- Practice address
- 8623 N Wayne Rd
Westland, MI 48185-1137 - Phone
- (734) 367-0469
- NPI assigned
- Jan 8, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 6301018111 | MI | Primary |
Addresses
Primary practice location
8623 N Wayne Rd
Westland, MI 48185-1137
Mailing address
6434 Kendal St
Dearborn, MI 48126-2149
Phone (313) 520-0055
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6301018111 | MI | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hegira Health, Inc. | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Primary Care Clinic/Center
- Westland, MI
- NPI 1477141356
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1578441600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1578441600000",
"number": "1700426699",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6434 KENDAL ST",
"city": "DEARBORN",
"state": "MI",
"postal_code": "481262149",
"telephone_number": "313-520-0055"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8623 N WAYNE RD",
"city": "WESTLAND",
"state": "MI",
"postal_code": "481851137",
"telephone_number": "734-367-0469"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FAKHERDDINE",
"first_name": "REEM",
"middle_name": "BAHA",
"name_prefix": "Miss",
"credential": "MA TLLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-01-08",
"last_updated": "2020-01-08",
"certification_date": "2020-01-08",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "MI",
"license": "6301018111",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Westland, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.