DR. SRIDEVI KODALI (NPI# 1053358630) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053358630 |
| Entity Type | Individual |
| Full Name | DR. SRIDEVI KODALI |
| Credential | M.D. |
| Practice Address |
17940 Farmington Rd Suite 230 Livonia MI 48152-4444 |
| Mailing Address |
17940 Farmington Road Suite 230 Livonia MI 48152-2851 |
| Practice Telephone | 7344224748 |
| Practice Fax Number | 7344225076 |
| Mailing Telephone | 7344224748 |
| Mailing Fax Number | 7344225076 |
| Enumeration Date | 2006-06-01 |
| Last Update Date | 2015-11-04 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
407429 | MI | Allopathic & Osteopathic Physicians |
| Y | 2084P0804X |
Psychiatry & Neurology Specialization: Child & Adolescent Psychiatry |
407429 | MI | Allopathic & Osteopathic Physicians |
| Street Address |
17940 FARMINGTON RD SUITE 230 |
| City | LIVONIA |
| State | MI |
| Zip Code | 48152-4444 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962409292 | Jeffrey Paul Berger | Internal Medicine | 17940 Farmington Rd, Suite 140, Livonia, MI 48152-3157 | 2005-07-01 |
| 1154966489 | Michelle Marie Zmich | Massage Therapist | 17940 Farmington Rd, Livonia, MI 48152-4444 | 2019-11-11 |
| 1164996385 | Laura Roell | Psychologist | 17940 Farmington Rd, Livonia, MI 48152-4444 | 2019-01-22 |
| 1750829263 | Jennifer Page Crystal | Counselor | 17940 Farmington Rd, Livonia, MI 48152-4444 | 2017-02-03 |
| 1013331651 | Patrick Murphy | Psychologist | 17940 Farmington Rd, Suite 280, Livonia, MI 48152-4444 | 2014-02-18 |
| 1164844890 | Emily Nadis Silver | Social Worker | 17940 Farmington Rd, Livonia, MI 48152-4444 | 2014-01-15 |
| 1972932515 | Jurgita Atanaskovski | Psychologist | 17940 Farmington Rd, Livonia, MI 48152-4444 | 2013-11-04 |
| 1356695134 | Jennifer Seim-andrew | Counselor | 17940 Farmington Rd, Suite 225, Livonia, MI 48152 | 2012-11-01 |
| 1932456688 | Basma Haddad | Psychologist | 17940 Farmington Rd, Livonia, MI 48152-4444 | 2012-08-13 |
| 1083986228 | Angela Mary Pecsenye | Counselor | 17940 Farmington Rd, Livonia, MI 48152-4444 | 2012-02-03 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326648171 | Hillary Fitzsimmons Psyd Pllc | Clinic/Center | 19455 Weyhar St, Livonia, MI 48152 | 2020-10-30 |
| 1639780968 | Goyanka Ranganathan | Student in an Organized Health Care Education/Training Program | Ipc Primary Care Internal Medicine, 37595 Seven Mile Road, Suite 340, Livonia, MI 48152 | 2020-08-11 |
| 1457988552 | Adam Ouellette | Student in an Organized Health Care Education/Training Program | St. Joe's Outpatient Psychiatry and Counseling Center, 37595 Seven Mile Rd, Suite 230, Livonia, MI 48152 | 2020-03-26 |
| 1972006047 | Genise Kerner Md PC | Clinic/Center | 37675 Pembrooke Ave, Livonia, MI 48152 | 2018-03-14 |
| 1205340593 | Rafal Hamamh | Dentist | 37595 7 Mile Rd Ste 4450, Livonia, MI 48152 | 2017-11-22 |
| 1053830489 | Felicia Cerise Reese | Registered Nurse | 17197 N. Laurel Park Drive, 555, Livonia, MI 48152 | 2017-09-18 |
| 1164943882 | Muhammad Yasir | Student in an Organized Health Care Education/Training Program | 37595 Seven Mile Rd. #340, Livonia, MI 48152 | 2017-07-03 |
| 1184154544 | St Mary Mercy Physician Practices | Clinic/Center | 39201 7 Mile Rd Bldg Room140, Livonia, MI 48152 | 2017-06-18 |
| 1912437518 | Divonne Touch | Clinic/Center | 18298 Middlebelt, Liviona, MI 48152 | 2017-06-15 |
| 1861922445 | Cheryl Lang | Physical Therapist | 17177 N Laurel Park Drive, Suite 417, Livonia, MI 48152 | 2017-06-15 |
| Find all providers in zip 48152 | ||||
| Taxonomy Code | 2084P0804X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Child & Adolescent Psychiatry |
| Child & Adolescent Psychiatry is a subspecialty of psychiatry with additional skills and training in the diagnosis and treatment of developmental, behavioral, emotional, and mental disorders of childhood and adolescence. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538390133 | Behavioral Health Associates Pllc | Psychiatry & Neurology | 19500 Middlebelt Rd, Suite 350e, Livonia, MI 48152-2196 | 2009-07-30 |
| 1053466946 | Carol Denise Crouch-ross | Psychiatry & Neurology | 19811 Farmington Rd, Livonia, MI 48152-1444 | 2007-01-24 |
| 1972032423 | Rachel Rose Santoro | Psychiatry & Neurology | 16836 Newburgh Rd, Livonia, MI 48154-1600 | 2017-06-08 |
| 1588910707 | Carol Crouch-ross Md Pllc | Psychiatry & Neurology | 19811 Farmington Rd, Livonia, MI 48152-1444 | 2012-07-25 |
| 1356418347 | Aleksandra Wilanowski | Psychiatry & Neurology | 17177 N Laurel Park Dr, Suite 437, Livonia, MI 48152-2693 | 2006-11-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316376056 | Esmaeil Emami | Psychiatry & Neurology | 2955 Franklin Rd, Bloomfield Hills, MI 48302-0917 | 2013-11-04 |
| 1154760312 | Samantha Fugate Kennedy | Psychiatry & Neurology | 909 Fee Rd Ste B119, East Lansing, MI 48824 | 2013-06-21 |
| 1407199961 | David Donald Krohn | Psychiatry & Neurology | 563 Highland Park Dr, Traverse City, MI 49686-2863 | 2013-04-03 |
| 1164712055 | Tatjana Maric | Psychiatry & Neurology | 420 Baltimore Dr Ne, Grand Rapids, MI 49503-3934 | 2011-04-12 |
| 1972893824 | Katherine Barbara Krive | Psychiatry & Neurology | 801 S Waverly Rd Ste 100, Lansing, MI 48917-4200 | 2011-04-12 |
| 1104128602 | Hope Network Behavioral Health Services | Psychiatry & Neurology | 3361 36th Street, Grand Rapids, MI 49512 | 2010-12-03 |
| 1295056653 | Veronica Yap Tan | Psychiatry & Neurology | 23354 Portage Way, Apt. 2212, Novi, MI 48375 | 2010-06-18 |
| 1548588874 | Katie Alanna Keller | Psychiatry & Neurology | 79 Alexandrine West, Detroit, MI 48201 | 2010-05-11 |
| 1235375775 | Kristine Baker | Psychiatry & Neurology | 721 Cherokee St, Traverse City, MI 49684-1401 | 2009-01-06 |
| 1689820078 | Margaret Mary Casey | Psychiatry & Neurology | 1326 Saint Antoine St, Detroit, MI 48226-2301 | 2008-08-18 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.