Individual provider Active NPI

Seyed Aboufazel Hosseini Nasab

  • Clinical Psychologist
  • Ann Arbor, MI
National Provider Identifier
1992452932
Registry record updated Jun 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
6361008065 Issued in MI
Practice address
2350 Washtenaw Ave Ste 3
Ann Arbor, MI 48104
Phone
(734) 215-5853
NPI assigned
Mar 9, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 16, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 6362009752 MI
Clinical Psychologist 103TC0700X 6361008065 MI Primary

Addresses

Primary practice location

2350 Washtenaw Ave Ste 3
Ann Arbor, MI 48104

Mailing address

343 S McCord Rd
Holland, OH 43528-8742
Phone (567) 702-0900

Other practice location 1

41800 W 11 Mile Rd Ste 110
Novi, MI 48375
Phone (877) 693-5543

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
6362009752MIMDMental Health Counselor
6361008065MIMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Judson Center, Inc. Clinical PastSince Mar 1, 2022 Accepting new patients
Joy Family Center Past Accepting new patients

Organizations & group practices 2

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": "1646784000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750032000000",
    "number": "1992452932",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "343 S MCCORD RD",
            "city": "HOLLAND",
            "state": "OH",
            "postal_code": "435288742",
            "telephone_number": "567-702-0900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2350 WASHTENAW AVE STE 3",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "48104",
            "telephone_number": "734-215-5853"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "41800 W 11 Mile Rd Ste 110",
            "address_purpose": "LOCATION",
            "city": "Novi",
            "state": "MI",
            "postal_code": "48375",
            "country_code": "US",
            "telephone_number": "877-693-5543",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HOSSEINI NASAB",
        "first_name": "SEYED ABOUFAZEL",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-03-09",
        "last_updated": "2025-06-16",
        "certification_date": "2025-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MI",
            "license": "6362009752",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6361008065",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ann Arbor, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2025; 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.