Individual provider Active NPI

Nausheen Masood, PHD

  • Clinical Psychologist
  • Canton, MI
National Provider Identifier
1952966913
Registry record updated Feb 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
6301017742 Issued in MI
Practice address
5840 N Canton Center Rd Ste 282
Canton, MI 48187-2684
Phone
(734) 335-0161
NPI assigned
May 6, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 10, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 6301017742 MI Primary

Addresses

Primary practice location

5840 N Canton Center Rd Ste 282
Canton, MI 48187-2684

Mailing address

5840 N Canton Center Rd Ste 282
Canton, MI 48187-2684

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
6301017742MIMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Wild Blooms Therapy LLC Clinical CurrentSince Feb 14, 2021 Accepting new patients

Locations

5840 N Canton Center Rd
Ste 221
Canton, MI 48187
Phone (773) 454-4898

5840 N Canton Center Rd
Ste 282
Canton, MI 48187
Phone (734) 335-0161

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1557100800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612915200000",
    "number": "1952966913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5840 N CANTON CENTER RD STE 282",
            "city": "CANTON",
            "state": "MI",
            "postal_code": "481872684"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5840 N CANTON CENTER RD STE 282",
            "city": "CANTON",
            "state": "MI",
            "postal_code": "481872684",
            "telephone_number": "734-335-0161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASOOD",
        "first_name": "NAUSHEEN",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-05-06",
        "last_updated": "2021-02-10",
        "certification_date": "2021-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6301017742",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canton, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 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.