DR. SHANTI RENEE MITCHELL (NPI# 1467715110) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1467715110 |
Entity Type | Individual |
Full Name | DR. SHANTI RENEE MITCHELL |
Credential | M.D. |
Practice Address |
39450 W 12 Mile Rd Novi MI 48377-3600 |
Practice Telephone | 2486617393 |
Mailing Telephone | 2486617393 |
Enumeration Date | 2012-06-18 |
Last Update Date | 2018-05-23 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
4301101308 | MI | Allopathic & Osteopathic Physicians |
Y | 2084P0804X |
Psychiatry & Neurology Specialization: Child & Adolescent Psychiatry |
4301101308 | MI | Allopathic & Osteopathic Physicians |
Address | Telephone Number | Fax Number |
---|---|---|
1500 E Medical Center Dr, Mchc, F6135, Ann Arbor, MI 481095000 | 7347646875 |
Street Address |
39450 W 12 MILE RD |
City | NOVI |
State | MI |
Zip Code | 48377-3600 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1801994512 | Heather Heilman | Social Worker | 39450 W 12 Mile Rd, Novi, MI 48377-3600 | 2006-09-20 |
1750926846 | Bryce Alexander Groshek | Physical Therapist | 39450 W 12 Mile Rd, Novi, MI 48377-3600 | 2019-11-12 |
1962975268 | Kelly Nohl | Dietitian, Registered | 39450 W 12 Mile Rd, Novi, MI 48377-3600 | 2019-01-09 |
1285121376 | Michele A Zubalik | Physical Therapist | 39450 W 12 Mile Rd, Novi, MI 48377-3600 | 2018-04-16 |
1295230944 | Rebecca Lynn Knodel | Occupational Therapist | 39450 W 12 Mile Rd, Novi, MI 48377-3600 | 2018-03-26 |
1275036709 | David Tomsich | Physical Therapist | 39450 W 12 Mile Rd, Novi, MI 48377-3600 | 2018-03-12 |
1760985170 | Ashley Nebel | Physical Therapist | 39450 W 12 Mile Rd, Novi, MI 48377-3600 | 2018-03-12 |
1750883104 | Melissa Joy Simon | Physical Therapist | 39450 W 12 Mile Rd, Novi, MI 48377-3600 | 2018-03-01 |
1891297404 | Michelle Louise Thibodeau | Physical Therapist | 39450 W 12 Mile Rd, Novi, MI 48377-3600 | 2018-02-28 |
1609384569 | Alexandrina Berghian | Nurse Practitioner | 39450 W 12 Mile Rd, Novi, MI 48377-3600 | 2018-01-12 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1679075758 | Andrea Campbell | Nurse Practitioner | 44000 W 12 Mile Rd Ste 113, Novi, MI 48377 | 2018-03-05 |
1811421928 | Michigan Eye and Contact Lens Pllc | Optometrist | 42081 14 Mile Road, Novi, MI 48377 | 2017-04-14 |
1336695691 | Deanna Lynne Klein | Speech-Language Pathologist | 44140 Fox Run Road, Novi, MI 48377 | 2016-08-28 |
1871940973 | Jaime Durante | Nurse Practitioner | 44070 W. 12 Mile Rd, Suite 100, Novi, MI 48377 | 2016-05-18 |
1508225624 | Trilogy Healthcare of Oakland II, LLC | Skilled Nursing Facility | 41795 W 12 Mile Road, Novi, MI 48377 | 2016-02-17 |
1144688854 | Hussein Azzam | Allergy & Immunology | 46325 W 12 Mile Rd Ste 215, Novi, MI 48377 | 2016-02-09 |
1598120164 | Nova Counseling Services Inc. | Counselor | 41650 Clemens Circle, Novi, MI 48377 | 2015-12-23 |
1891174587 | Reem Mariam Mansour | Occupational Therapist | 44125 West 12 Mile Rd E-123, Novi, MI 48377 | 2015-05-27 |
1154747095 | Ali Hassan Ismail | Dentist | 41920 Wolfe Pass, Novi, MI 48377 | 2014-03-17 |
1558703876 | Twelve Oaks Orthodontics Pllc | Dentist | 44110 W 12 Mile Rd, Suite 100, Novi, MI 48377 | 2013-07-29 |
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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 |
---|---|---|---|---|
1295056653 | Veronica Yap Tan | Psychiatry & Neurology | 23354 Portage Way, Apt. 2212, Novi, MI 48375 | 2010-06-18 |
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 |
1548588874 | Katie Alanna Keller | Psychiatry & Neurology | 79 Alexandrine West, Detroit, MI 48201 | 2010-05-11 |
1538390133 | Behavioral Health Associates Pllc | Psychiatry & Neurology | 19500 Middlebelt Rd, Suite 350e, Livonia, MI 48152-2196 | 2009-07-30 |
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.