Individual provider Active NPI

Sophia Awad Atifah

  • Psychiatric/Mental Health Nurse Practitioner
  • Dearborn, MI
National Provider Identifier
1760278048
Registry record updated Apr 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
4704339547 Issued in MI
Practice address
6451 Schaefer Rd
Dearborn, MI 48126-2212
Phone
(313) 945-8138
Fax
(313) 203-3390
NPI assigned
Apr 15, 2025
Last updated
Apr 22, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 4704339547 MI Primary

Addresses

Primary practice location

6451 Schaefer Rd
Dearborn, MI 48126-2212

Mailing address

19445 W Warren Ave
Detroit, MI 48228-3361
Phone (734) 324-0055

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: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260518001550 MI Practitioner - Nurse Practitioner 4880163096 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

6451 Schaefer Rd
Dearborn, MI 48126-2212

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4704339547MIMDPsychiatric/Mental Health Nurse Practitioner

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, 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": "1744675200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776816000000",
    "number": "1760278048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19445 W WARREN AVE",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482283361",
            "telephone_number": "734-324-0055",
            "fax_number": "313-281-2235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6451 SCHAEFER RD",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481262212",
            "telephone_number": "313-945-8138",
            "fax_number": "313-203-3390"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ATIFAH",
        "first_name": "SOPHIA",
        "middle_name": "AWAD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-04-15",
        "last_updated": "2026-04-22",
        "certification_date": "2026-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MI",
            "license": "4704339547",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dearborn, MI

Sources for this page

Verify at the official NPI Registry.