Prathima Mistry, PH.D. LLP

Primary specialty

PsychologistTaxonomy code 103T00000X

License

6301012647 Issued in MI

Practice address

2075 W Big Beaver Rd
Suite 520
Troy, MI 48084-3407

Phone

(248) 646-6659

NPI assigned

Apr 17, 2007

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

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

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 and National Provider Directory roles.

• International Therapy Solutions, PLLC

  • Clinical Social Worker
  • Warren, MI
  • NPI 1093254120
  Medicare reassignment NPD

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

{
    "created_epoch": "1176768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686268800000",
    "number": "1902021405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11480 E 13 MILE RD",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480932566",
            "telephone_number": "586-216-9253"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2075 W BIG BEAVER RD",
            "address_2": "SUITE 520",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480843407",
            "telephone_number": "248-646-6659"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MISTRY",
        "first_name": "PRATHIMA",
        "credential": "PH.D. LLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-17",
        "last_updated": "2023-06-09",
        "certification_date": "2023-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "22251",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MI",
            "license": "6301012647",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Zara Mirza
• Vijay Mishra, OTR
• Svetlana M Mishulin, MD
• Trisha Misiewicz, PT, DPT
• Dwijen C Misra, MD
• Mitchell Folbe M D P C
• Mitchell H Folbe MD
• Christina Mitchell
• Jeffery Mitchell
• Lakaysha Mitchell

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.