NICOLE ELIZABETH MAZUR (NPI# 1629550926) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629550926 |
| Entity Type | Individual |
| Full Name | NICOLE ELIZABETH MAZUR |
| Credential | BA |
| Practice Address |
13333 Allen Rd Southgate MI 48195-2216 |
| Mailing Address |
13101 Allen Rd Southgate MI 48195-2216 |
| Practice Telephone | 7347857705 |
| Practice Fax Number | 7342873071 |
| Mailing Telephone | 7347857700 |
| Enumeration Date | 2018-09-04 |
| Last Update Date | 2019-07-19 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
6301017910 | MI | Behavioral Health & Social Service Providers |
| Street Address |
13333 ALLEN RD |
| City | SOUTHGATE |
| State | MI |
| Zip Code | 48195-2216 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881944981 | Gyda Dogg Einarsdottir | Student in an Organized Health Care Education/Training Program | 13333 Allen Rd, Southgate, MI 48195-2216 | 2012-09-16 |
| 1871140905 | Amy Wilson | Counselor | 13333 Allen Rd, Southgate, MI 48195-2216 | 2019-08-22 |
| 1588228365 | Jessica Collins | Counselor | 13333 Allen Rd, Southgate, MI 48195-2216 | 2019-04-26 |
| 1356811129 | Timothy Patrick Egan Jr. | Social Worker | 13333 Allen Rd, Southgate, MI 48195-2216 | 2018-12-05 |
| 1710478821 | Reem Nasr | Psychologist | 13333 Allen Rd, Southgate, MI 48195-2216 | 2018-05-24 |
| 1033619234 | Bianca Lenise Smith | Social Worker | 13333 Allen Rd, Southgate, MI 48195-2216 | 2018-02-15 |
| 1205363587 | Erika Marie Lawnicki | Student in an Organized Health Care Education/Training Program | 13333 Allen Rd, Southgate, MI 48195-2216 | 2017-05-17 |
| 1750818134 | Ariel Baranowski | Student in an Organized Health Care Education/Training Program | 13333 Allen Rd, Southgate, MI 48195-2216 | 2017-05-17 |
| 1508213224 | Alysia Haddix | Student in an Organized Health Care Education/Training Program | 13333 Allen Rd, Southgate, MI 48195-2216 | 2016-05-23 |
| 1780045104 | Lakenya Hill | Community Health Worker | 13333 Allen Rd, Southgate, MI 48195-2216 | 2016-03-11 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780206656 | Destiny D Harris | Social Worker | 14799, Southgate, MI 48195 | 2020-05-13 |
| 1285102368 | Svs Vision Inc | Eyewear Supplier (Equipment, not the service) | 16256 Fort St, Southgate, MI 48195 | 2018-11-07 |
| 1003382979 | Saran Charisse Watts | Case Manager/Care Coordinator | 31101 Allen Rd, Building 5, Southgate, MI 48195 | 2018-10-18 |
| 1255824025 | Kiesta Janell Lindsey | Social Worker | 13101 Allen Rd Bldg 4-f, Southgate, MI 48195 | 2018-06-07 |
| 1417473224 | Suzette Michele Watson | Nurse Practitioner | 14319 Dix-toledo, Southgate, MI 48195 | 2017-08-15 |
| 1275069486 | Liza Du Plessis | Student in an Organized Health Care Education/Training Program | 13111 Allen Road, Southgate, MI 48195 | 2017-05-08 |
| 1497290456 | Beaumont Health | Clinic/Center | 15777 Northline, Southgate, MI 48195 | 2016-12-30 |
| 1184172876 | Felicia Wilson | Licensed Practical Nurse | 15771 Wildemere, Southgate, MI 48195 | 2016-09-12 |
| 1225487978 | Stacey Petrick-strickland | Technician, Other | 12189 Agnes, Southgate, MI 48195 | 2016-06-03 |
| 1205298486 | Ashley Francis | Hearing Instrument Specialist | 18800 Eureka Rd., Southgate, MICHIGAN 48195 | 2016-03-25 |
| Find all providers in zip 48195 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124254792 | Camey Springer | Psychologist | 13101 Alan Rd, Southgate, MI 48195-2216 | 2009-06-09 |
| 1326297672 | Michael Paul Lingar | Psychologist | 14799 Dix Toledo Rd, Suite 1100, Southgate, MI 48195-2507 | 2008-09-11 |
| 1518476753 | Ciara Donaldson | Psychologist | 13305 Reeck Road, Southgate, MI 48195 | 2017-09-20 |
| 1497299309 | Jacqueline Fritts | Psychologist | 13305 Reeck Road, Southgate, MI 48195-1879 | 2016-12-12 |
| 1841680824 | Jessica Toro | Psychologist | 13101 Allen Road, Southgate, MI 48195 | 2015-01-29 |
| 1023415098 | Rebecca Rouse | Psychologist | 13101 Allen Rd, Southgate, MI 48195-2216 | 2014-11-19 |
| 1568719862 | Wendy Sue Dawson | Psychologist | 13101 Allen Rd, Southgate, MI 48195-2216 | 2012-08-07 |
| 1922354224 | Michelle Edwards | Psychologist | 13101 Allen Rd, Southgate, MI 48195-2216 | 2012-07-24 |
| 1053677369 | Debora Marie Collins | Psychologist | 13101 Allen Rd, Southgate, MI 48195-2216 | 2012-04-11 |
| 1023380268 | Toni Renee Pruss | Psychologist | 19401 Northline Rd, Southgate, MI 48195-2277 | 2012-02-03 |
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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.