Individual provider Active NPI

Sanaa Nadim Haidar, LPC, CAADC

  • Mental Health Counselor
  • Dearborn Heights, MI
National Provider Identifier
1952730624
Registry record updated Jun 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
6401017627 Issued in MI
Practice address
5734 Kingsbury St
Dearborn Heights, MI 48127-3118
Phone
(313) 258-2583
NPI assigned
Nov 4, 2013
Last updated
Jun 12, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 6401017627 MI Primary

Addresses

Primary practice location

5734 Kingsbury St
Dearborn Heights, MI 48127-3118

Mailing address

5734 Kingsbury St
Dearborn Heights, MI 48127-3118
Phone (313) 258-2583

Other practice location 1

6451 Schaefer Rd
Dearborn, MI 48126-2212
Phone (313) 945-8127 ext. 229

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241106003458 MI Practitioner - Mental Health Counselor 1557764255 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Wayne State University School of Medicine, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

14733 Champaign Rd
Allen Park, MI 48101-1616
Phone (313) 258-2583

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
SBH Ventures LLC CurrentSince Oct 5, 2024 Accepting new patients

Locations

14733 Champaign Rd
Allen Park, MI 48101
Phone (313) 258-2583

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": "1383523200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623456000000",
    "number": "1952730624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5734 KINGSBURY ST",
            "city": "DEARBORN HEIGHTS",
            "state": "MI",
            "postal_code": "481273118",
            "telephone_number": "313-258-2583",
            "fax_number": "313-624-9418"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5734 KINGSBURY ST",
            "city": "DEARBORN HEIGHTS",
            "state": "MI",
            "postal_code": "481273118",
            "telephone_number": "313-258-2583"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6451 Schaefer Rd",
            "address_purpose": "LOCATION",
            "city": "Dearborn",
            "state": "MI",
            "postal_code": "481262212",
            "country_code": "US",
            "telephone_number": "313-945-8127 x229",
            "fax_number": "313-624-9418",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HAIDAR",
        "first_name": "SANAA",
        "middle_name": "NADIM",
        "name_prefix": "Mrs.",
        "credential": "LPC, CAADC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-11-04",
        "last_updated": "2021-06-12",
        "certification_date": "2021-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MI",
            "license": "6401017627",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dearborn Heights, MI

Sources for this page

Verify at the official NPI Registry.