KELLIE COOPER-SECREST (NPI# 1316437205) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1316437205 |
Entity Type | Individual |
Full Name | KELLIE COOPER-SECREST |
Credential | LLP |
Practice Address |
835 Mason St Ste B220 Dearborn MI 48124-2262 |
Practice Telephone | 3135619064 |
Enumeration Date | 2018-05-16 |
Last Update Date | 2018-05-16 |
Gender Code | F |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 103TC0700X |
Psychologist Specialization: Clinical |
6301016322 | MI | Behavioral Health & Social Service Providers |
Street Address |
835 MASON ST STE B220 |
City | DEARBORN |
State | MI |
Zip Code | 48124-2262 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1770640252 | Vanessa Charnock | Psychologist | 835 Mason St Ste B220, Dearborn, MI 48124-2262 | 2007-01-03 |
1275130718 | Hillary Easton | Psychologist | 835 Mason St Ste B220, Dearborn, MI 48124-2262 | 2020-10-07 |
1689280182 | Tori Andrews | Counselor | 835 Mason St Ste B220, Dearborn, MI 48124-2262 | 2020-09-20 |
1295340362 | Lina Bazzi | Counselor | 835 Mason St Ste B220, Dearborn, MI 48124-2262 | 2020-09-15 |
1720604457 | Mckendra Cramer | Psychologist | 835 Mason St Ste B220, Dearborn, MI 48124-2262 | 2020-06-18 |
1114557972 | Georgeanne Karatsinides | Counselor | 835 Mason St Ste B220, Dearborn, MI 48124-2262 | 2020-01-21 |
1023648953 | Yasmeen Saba El-masry | Psychologist | 835 Mason St Ste B220, Dearborn, MI 48124-2262 | 2020-01-20 |
1447880463 | Olivia Ann Moquin | Psychologist | 835 Mason St Ste B220, Dearborn, MI 48124-2262 | 2020-01-17 |
1083277339 | Jakob Daniel Williams | Psychologist | 835 Mason St Ste B220, Dearborn, MI 48124-2262 | 2019-04-22 |
1043795628 | Lisa Michelle Green | Counselor | 835 Mason St Ste B220, Dearborn, MI 48124-2262 | 2018-09-28 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1396389524 | Pharma A, LLC | Pharmacy | 23916 Michigan Ave, Dearborn, MI 48124 | 2019-10-31 |
1225683725 | Aysha Said | Behavior Technician | 1369 Porter St, Dearborn, MI 48124 | 2019-08-02 |
1881257772 | Leen Nusairat | Internal Medicine | Beaumont Health-dearborn Campus, 18101 Oakwood Blvd, Dearborn, MI 48124 | 2019-04-17 |
1417413360 | Gary C. Veraghen, Dds, PC | Dentist | 22100 W. Outer Drive, Dearborn, MI 48124 | 2019-02-15 |
1982168787 | Fnu Asma Manzar | Physical Therapist | Global Physical Therapy Services, Inc, 22819 Michigan Avenue, Dearborn, MI 48124 | 2019-01-25 |
1639640162 | Jernia Lashawn Usher | Behavior Technician | 1360 Porter St Lower Level, Dearborn, MI 48124 | 2018-12-10 |
1710456470 | Samar Fouad Hannawi | Psychologist | 3815 Pelham Street, Suite #13, Dearborn, MI 48124 | 2018-11-24 |
1881178747 | Sarah Chehab | Psychologist | 835 Mason St Suite 220b, Dearborn, MI 48124 | 2018-09-17 |
1568948289 | Ibrahim M Basma | Pharmacist | 22521 Michigan Avenue, Dearborn, MI 48124 | 2018-07-16 |
1669961942 | Jacqueline E Domzalski | Technician, Other | 3231 S. Gulley, Suite E, Dearborn, MI 48124 | 2018-05-02 |
Find all providers in zip 48124 |
Taxonomy Code | 103TC0700X |
Grouping | Behavioral Health & Social Service Providers |
Classification | Psychologist |
Specialization | Clinical |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1417575762 | Authenticity Psychological Services | Psychologist | 24314 Cherry Hill St, Dearborn, MI 48124-1358 | 2020-07-13 |
1144798216 | Janelle A Smith | Psychologist | 2881 Monroe St # 201, Dearborn, MI 48124-3475 | 2018-11-07 |
1881178747 | Sarah Chehab | Psychologist | 835 Mason St Suite 220b, Dearborn, MI 48124 | 2018-09-17 |
1851696488 | Ellen Louise Keyt | Psychologist | Counseling & Resource Center of Dearborn, 19855 W. Outer Drive, Dearborn, MI 48124 | 2011-01-12 |
1649574526 | Tiffany Zlatich Tuttle | Psychologist | 19855 West Outer Dr Ste 104w, Dearborn, MI 48124-2022 | 2011-01-06 |
1689984213 | Justin Wayne Peer | Psychologist | 1 Parklane Blvd Ste 1210e, Dearborn, MI 48126-4283 | 2010-10-17 |
1952637126 | Melissa Marie Farrell | Psychologist | 1 Parklane Blvd, Dearborn, MI 48126 | 2009-10-23 |
1558594283 | George Psychological Services PC | Psychologist | 2314 Monroe, Dearborn, MI 48124-3045 | 2009-08-28 |
1063663714 | Maritaconstance Supan | Psychologist | 934 Mason St, Dearborn, MI 48124-2215 | 2008-09-30 |
1588710222 | Manuel Alexander Manrique | Psychologist | 22967 Outer Dr, Dearborn, MI 48124-4248 | 2007-01-26 |
Find all providers in DEARBORN |
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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.