Individual provider Active NPI

Raji S George, DNP, PMHNP-BC,FNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Bloomfield Hills, MI
National Provider Identifier
1831758689
Registry record updated Apr 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
4704256862 Issued in MI
Practice address
1760 S Telegraph Rd Ste 220
Bloomfield Hills, MI 48302-0183
Phone
(517) 492-0784
Fax
(248) 671-0922
NPI assigned
Jun 6, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 4704256862 MI
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 4704256862 MI Primary

Addresses

Primary practice location

1760 S Telegraph Rd Ste 220
Bloomfield Hills, MI 48302-0183

Mailing address

1760 S Telegraph Rd Ste 220
Bloomfield Hills, MI 48302-0183
Phone (517) 492-0784

Other practice location 1

6016 W Maple Rd Ste 705
West Bloomfield, MI 48322-4411
Phone (248) 862-2551

Other practice location 2

2425 Military St Bldg 2
Port Huron, MI 48060-6692
Phone (810) 984-5700

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
I20200108000512 MI Practitioner - Nurse Practitioner 8820422413 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Wayne State University School of Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Downriver Mental Health Clinic PCGroup PAC ID 7911995139, 289 clinicians

Practice addresses (Care Compare)

5958 N Canton Ctr Rd
Suite 900
Canton, MI 48187-2740
Phone (734) 737-1200

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4704256862MIMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Downriver Mental Health Clinic PC CurrentSince Jul 30, 2022 Accepting new patients
Downriver Mental Health Clinic PC CurrentSince Jul 30, 2022 Accepting new patients

Locations

1760 S Telegraph Rd
Ste 220
Bloomfield Hills, MI 48302
Phone (248) 587-7618

1760 S Telegraph Rd
Ste 200
Bloomfield Township, MI 48302

5958 N Canton Center Rd
Ste 900
Canton, MI 48187
Phone (734) 727-1200

1400 Abbot Rd
Ste 400
East Lansing, MI 48823
Phone (810) 220-2787

20500 Eureka Rd
Ste 200
Taylor, MI 48180
Phone (734) 285-8282

Interoperability endpoints

  • Direct secure messaging: lifestancehealth.rajigeorge@150339.advancedmd-direct.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1559779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745971200000",
    "number": "1831758689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1760 S TELEGRAPH RD STE 220",
            "city": "BLOOMFIELD HILLS",
            "state": "MI",
            "postal_code": "483020183",
            "telephone_number": "517-492-0784",
            "fax_number": "248-671-0922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1760 S TELEGRAPH RD STE 220",
            "city": "BLOOMFIELD HILLS",
            "state": "MI",
            "postal_code": "483020183",
            "telephone_number": "517-492-0784",
            "fax_number": "248-671-0922"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6016 W Maple Rd Ste 705",
            "address_purpose": "LOCATION",
            "city": "West Bloomfield",
            "state": "MI",
            "postal_code": "483224411",
            "country_code": "US",
            "telephone_number": "248-862-2551",
            "fax_number": "248-757-8053",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2425 Military St Bldg 2",
            "address_purpose": "LOCATION",
            "city": "Port Huron",
            "state": "MI",
            "postal_code": "480606692",
            "country_code": "US",
            "telephone_number": "810-984-5700",
            "fax_number": "810-984-1886",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GEORGE",
        "first_name": "RAJI",
        "middle_name": "S",
        "name_prefix": "Ms.",
        "credential": "DNP, PMHNP-BC,FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-06",
        "last_updated": "2025-04-30",
        "certification_date": "2025-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704256862",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MI",
            "license": "4704256862",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomfield Hills, MI

Sources for this page

Verify at the official NPI Registry.