Haider Hassan Al Darweesh
Individual provider Active NPI Cognitive & Behavioral Psychologist · Dexter, MI
NPI 1982134664 · NPPES record last updated Jan 7, 2021
Key facts
- NPI
- 1982134664
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Cognitive & Behavioral Psychologist 103TB0200X
- License
- 6362009232 (MI)
- Practice address
- 3258 Broad St Ste 2
Dexter, MI 48130-1142 - Phone
- (734) 664-2528
- NPI assigned
- Jun 15, 2017
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6362009232 | MI | MD | Cognitive & Behavioral Psychologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician |
106S00000X | |||
| Cognitive & Behavioral Psychologist | 103TB0200X | 6362009232 | MI | Yes |
Addresses
Primary practice location
3258 Broad St Ste 2
Dexter, MI 48130-1142
Mailing address
23400 Michigan Ave Ste
Dearborn, MI 48124
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | Dexter | Direct |
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 7, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.