Myrtle Charisse Means, PHD

Primary specialty

PsychologistTaxonomy code 103T00000X

License

6301011889 Issued in MI

Practice address

23003 Greater Mack Ave Ste B
Saint Clair Shores, MI 48080-1965

Phone

(313) 574-6616

NPI assigned

Sep 20, 2006

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MI, GA2 enrollments

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 2

Specialty

Clinical Psychologist

Education

Other, 2000

Medicare assignment

May accept Medicare assignment

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

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.

• Myrtle C. Means, PH.D., P.C.

  • Clinical Psychologist
  • Saint Clair Shores, MI
  • NPI 1376722264

  GA

  Medicare reassignment NPD Authorized official
• Christina Haemmerle PHD PC

  • Clinical Psychologist
  • Rochester Hills, MI
  • NPI 1396894424
  NPD (past)

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566777600000",
    "number": "1710084801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11285 ELKINS RD STE D3",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300765835",
            "telephone_number": "313-574-6616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23003 GREATER MACK AVE STE B",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "480801965",
            "telephone_number": "313-574-6616"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11285 Elkins Rd Ste D3",
            "address_purpose": "LOCATION",
            "city": "Roswell",
            "state": "GA",
            "postal_code": "300765835",
            "country_code": "US",
            "telephone_number": "313-574-6616",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "19855 Outer Dr # 103",
            "address_purpose": "LOCATION",
            "city": "Dearborn",
            "state": "MI",
            "postal_code": "481242022",
            "country_code": "US",
            "telephone_number": "313-574-6616",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MEANS",
        "first_name": "MYRTLE",
        "middle_name": "CHARISSE",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-20",
        "last_updated": "2019-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MI",
            "license": "6301011889",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "68OE017280",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Ann R McReynolds, MD
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• Karissa Claire Medulla
• Daniel DJ Megler, MD
• Ahmed Abdel Meguid, MD
• Aston Mehr
• Kenneth J Meisel, LMSW

• Psychologist in Saint Clair Shores, MI
• Providers in Saint Clair Shores, MI by specialty
• Psychologist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2019; 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.