Patricia Sue Rousselo, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

6301009181 Issued in MI

Practice address

23 W 1St St
Monroe, MI 48161-2332

Phone

(734) 639-2262

Fax

(734) 621-5075

NPI assigned

Aug 23, 2024

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

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 Psychologist

Education

University of Toledo College of Medicine, 1993

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mindful Operations LLCGroup PAC ID 5799179123, 5 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

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.

• Mindful Operations LLC

  dba Humanistic Wellness Center

  • Clinical Psychologist
  • Monroe, MI
  • NPI 1437824315
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1724371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724371200000",
    "number": "1700619806",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5840 E DUNBAR RD UNIT 30",
            "city": "MONROE",
            "state": "MI",
            "postal_code": "481615032",
            "telephone_number": "734-735-5175"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23 W 1ST ST",
            "city": "MONROE",
            "state": "MI",
            "postal_code": "481612332",
            "telephone_number": "734-639-2262",
            "fax_number": "734-621-5075"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROUSSELO",
        "first_name": "PATRICIA",
        "middle_name": "SUE",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-08-23",
        "last_updated": "2024-08-23",
        "certification_date": "2024-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6301009181",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alexandria Root
• Dayna Root
• Ashlyn Riley Rose
• Justin Rothman
• Patricia G Rourke, PHD
• Nicole Marie Roy, LMT
• Michael Richard Rozich, PSYCHOLOGIST
• Elizabeth Ruddy, PT
• Jana Christine Ruddy, PT - PHYSICAL THERAP
• Taneesha Ruff

• Clinical Psychologist in Monroe, MI
• Providers in Monroe, MI by specialty
• Clinical Psychologist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2024; 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.