Individual provider Active NPI

Nichole Rae Mead-Hall, MA LLP

  • Psychologist
  • Flint, MI
National Provider Identifier
1972948925
Registry record updated Sep 24, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
6301015445 Issued in MI
Practice address
1309 S Linden Rd Ste C
Flint, MI 48532-3443
Phone
(810) 630-1152
Fax
(810) 630-9107
NPI assigned
May 3, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 24, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 6301015445 MI Primary

Addresses

Primary practice location

1309 S Linden Rd Ste C
Flint, MI 48532-3443

Mailing address

1309 S Linden Rd Ste C
Flint, MI 48532-3443
Phone (810) 630-1152

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
Master of Arts

State licenses

LicenseStateTypeSpecialty
6301015445MIMDPsychologist

NPI Registry JSON

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

{
    "created_epoch": "1367539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569283200000",
    "number": "1972948925",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1309 S LINDEN RD STE C",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485323443",
            "telephone_number": "810-630-1152",
            "fax_number": "810-630-9107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1309 S LINDEN RD STE C",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485323443",
            "telephone_number": "810-630-1152",
            "fax_number": "810-630-9107"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEAD-HALL",
        "first_name": "NICHOLE",
        "middle_name": "RAE",
        "credential": "MA LLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-05-03",
        "last_updated": "2019-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MI",
            "license": "6301015445",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flint, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2019; 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.