Individual provider Active NPI

Denise F Mansour, PSY.D., LLP, CTS

  • Psychologist
  • Novi, MI
National Provider Identifier
1972624716
Registry record updated Dec 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
6361003557 Issued in MI
Practice address
28175 Haggerty Rd
Novi, MI 48377-2903
Phone
(734) 265-0841
NPI assigned
Apr 2, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 27, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 6301013014 MI
Psychologist 103T00000X 6361003557 MI Primary

Addresses

Primary practice location

28175 Haggerty Rd
Novi, MI 48377-2903

Mailing address

109 Highland Dr
Bloomfield Hills, MI 48302-0358
Phone (248) 202-4192

Other practice location 1

109 Highland Dr
Bloomfield Hills, MI 48302-0358
Phone (248) 202-4192

Other identifiers 1

IdentifierTypeStateIssuer
3434247MedicaidMI

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

State licenses

LicenseStateTypeSpecialty
6361003557MIMDPsychologist
6301013014MIMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Arab American and Chaldean Council Past Accepting new patients
Oasis Counseling Center, PLLC PastSince Aug 20, 2025 Accepting new patients
Sally Barbat PLLC Psychologist PastSince Feb 13, 2021 Accepting new patients

Organizations & group practices 3

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": "1175472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672099200000",
    "number": "1972624716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 HIGHLAND DR",
            "city": "BLOOMFIELD HILLS",
            "state": "MI",
            "postal_code": "483020358",
            "telephone_number": "248-202-4192"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28175 HAGGERTY RD",
            "city": "NOVI",
            "state": "MI",
            "postal_code": "483772903",
            "telephone_number": "734-265-0841"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "109 Highland Dr",
            "address_purpose": "LOCATION",
            "city": "Bloomfield Hills",
            "state": "MI",
            "postal_code": "483020358",
            "country_code": "US",
            "telephone_number": "248-202-4192",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MANSOUR",
        "first_name": "DENISE",
        "middle_name": "F",
        "name_prefix": "Dr.",
        "credential": "PSY.D., LLP, CTS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-02",
        "last_updated": "2022-12-27",
        "certification_date": "2022-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6301013014",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MI",
            "license": "6361003557",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3434247",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Novi, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2022; 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.