NPIMap

Organization Active NPI

Oakland Health Associate of Waterford Clarkston

  • Psychiatry Physician
  • Waterford, MI
National Provider Identifier
1861980609
Registry record updated Mar 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
OAKLAND HEALTH ASSOCIATE OF WATERFORD CLARKSTON
Practice address
4576 W Walton Blvd
Waterford, MI 48329-4905
Phone
(586) 770-9409
NPI assigned
Apr 26, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2025

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

Authorized official

Name
Sebi R Fishta, LPC/PH.D (CAND)NPI 1184999070
Title
Ceo
Phone
(586) 770-9409

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0800X Primary

Addresses

Primary practice location

4576 W Walton Blvd
Waterford, MI 48329-4905

Mailing address

4567 W Walton Blvd
Waterford, MI 48329-4078
Phone (586) 770-9409

Other names 1

  • Oakland Health Associates of Waterford and Clarkston Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250611003947 MI Part B Supplier - Clinic/Group Practice 9931619517 Receives reassigned benefits from 2 practitioners
Practice locations: Waterford, MI

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 18

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1524700800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1743120000000",
    "number": "1861980609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4567 W WALTON BLVD",
            "city": "WATERFORD",
            "state": "MI",
            "postal_code": "483294078",
            "telephone_number": "586-770-9409"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4576 W WALTON BLVD",
            "city": "WATERFORD",
            "state": "MI",
            "postal_code": "483294905",
            "telephone_number": "586-770-9409"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OAKLAND HEALTH ASSOCIATE OF WATERFORD CLARKSTON",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-04-26",
        "last_updated": "2025-03-28",
        "certification_date": "2025-03-28",
        "status": "A",
        "authorized_official_last_name": "FISHTA",
        "authorized_official_first_name": "SEBI",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "586-770-9409",
        "authorized_official_credential": "LPC/PH.D (CAND)"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Oakland Health Associates of Waterford and Clarkston",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Oakland Health Associates of Waterford and Clarkston",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Waterford, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.