Provider Demographics
NPI:1134909526
Name:MICHIGAN MENTAL HEALTH CENTERS STAFFING LLC PSYCOGNITION
Entity type:Organization
Organization Name:MICHIGAN MENTAL HEALTH CENTERS STAFFING LLC PSYCOGNITION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AMITA
Authorized Official - Middle Name:
Authorized Official - Last Name:KAPOOR
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:248-716-0401
Mailing Address - Street 1:5797 FELSKE DR
Mailing Address - Street 2:
Mailing Address - City:BRIGHTON
Mailing Address - State:MI
Mailing Address - Zip Code:48116-9505
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:888-244-7140
Practice Address - Street 1:5797 FELSKE DR
Practice Address - Street 2:
Practice Address - City:BRIGHTON
Practice Address - State:MI
Practice Address - Zip Code:48116-9505
Practice Address - Country:US
Practice Address - Phone:248-302-2648
Practice Address - Fax:888-244-7140
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-03
Last Update Date:2025-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty