Faten Y Bazzi, MS, LLP

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

6361007094 Issued in MI

Practice address

363 W Big Beaver Rd Ste 315
Troy, MI 48084-5242

Phone

(248) 354-8460

NPI assigned

Nov 10, 2010

Last updated

Oct 27, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: pcerecords.acc@direct.mihin.net

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.

• Arab American and Chaldean Council

  dba Acc

  • Psychiatry Physician
  • Troy, MI
  • NPI 1689006975
  NPD (past)

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

{
    "created_epoch": "1289347200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635292800000",
    "number": "1871894675",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3710 EASTHAM RD",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481201049",
            "telephone_number": "313-505-0594"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "363 W BIG BEAVER RD STE 315",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480845242",
            "telephone_number": "248-354-8460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAZZI",
        "first_name": "FATEN",
        "middle_name": "Y",
        "credential": "MS, LLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-11-10",
        "last_updated": "2021-10-27",
        "certification_date": "2021-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6301014548",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6361007094",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3434247",
            "state": "MI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "pcerecords.acc@direct.mihin.net",
            "affiliation": "N",
            "address_1": "363 W Big Beaver Rd Ste 315",
            "city": "Troy",
            "state": "MI",
            "country_code": "US",
            "postal_code": "480845242",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Stacey Lana Baugaard, O.D
• Daniel J. Baumann, O.D.
• Gema Bautista Morris, BCBA, LBA
• Angeline L Bayci, OTRL
• Charlotte Elaine Bazydlo
• Hassan A. Bazzi, D.O.
• Linda Bazzi
• BC Podiatry PLLC (Gentle Foot & Ankle Care LLC)
• Donald Samuel Beam III, M.D.
• Latoya Beard

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.