CORE PSYCH PLLC (NPI# 1871069039) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1871069039 |
| Entity Type | Organization |
| Organization Name | CORE PSYCH PLLC |
| Practice Address |
3815 Pelham St Dearborn MI 48124-3852 |
| Practice Telephone | 3134290470 |
| Mailing Telephone | 3134290470 |
| Enumeration Date | 2018-10-15 |
| Last Update Date | 2018-10-15 |
| Authorized Official Name | DR. SHADY SHEBAK (PSYCHIATRIST) |
| Authorized Official Telephone | 3134290470 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
Behavioral Health & Social Service Providers | ||
| N | 101YM0800X |
Counselor Specialization: Mental Health |
Behavioral Health & Social Service Providers | ||
| N | 103T00000X | Psychologist | Behavioral Health & Social Service Providers | ||
| N | 103TA0400X |
Psychologist Specialization: Addiction (Substance Use Disorder) |
Behavioral Health & Social Service Providers | ||
| N | 103TB0200X |
Psychologist Specialization: Cognitive & Behavioral |
Behavioral Health & Social Service Providers | ||
| N | 103TC0700X |
Psychologist Specialization: Clinical |
Behavioral Health & Social Service Providers | ||
| N | 103TC1900X |
Psychologist Specialization: Counseling |
Behavioral Health & Social Service Providers | ||
| N | 103TM1800X |
Psychologist Specialization: Mental Retardation & Developmental Disabilities |
Behavioral Health & Social Service Providers | ||
| N | 104100000X | Social Worker | Behavioral Health & Social Service Providers | ||
| N | 106H00000X | Marriage & Family Therapist | Behavioral Health & Social Service Providers | ||
| N | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
Allopathic & Osteopathic Physicians | ||
| N | 363A00000X | Physician Assistant | Physician Assistants & Advanced Practice Nursing Providers | ||
| Y | 1835P1300X |
Pharmacist Specialization: Psychiatric |
Pharmacy Service Providers |
| Street Address |
3815 PELHAM ST |
| City | DEARBORN |
| State | MI |
| Zip Code | 48124-3852 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518923325 | Andrew L Marcus | Psychiatry & Neurology | 3815 Pelham St, Suite 14, Dearborn, MI 48124-3852 | 2006-04-21 |
| 1073085411 | Heba Sobh | Pharmacist | 3815 Pelham St, Dearborn, MI 48124-3852 | 2018-12-26 |
| 1336665728 | Pelham Primary Care PC | Internal Medicine | 3815 Pelham St, Dearborn, MI 48124-3852 | 2017-08-17 |
| 1487178174 | Amy Amira Yousif | Nurse Practitioner | 3815 Pelham St, Dearborn, MI 48124-3852 | 2017-08-03 |
| 1568871382 | Pelham Pharmacy | Pharmacy | 3815 Pelham St, Suite 3, Dearborn, MI 48124-3852 | 2014-08-06 |
| 1568707594 | Neurology Care Center PC | Psychiatry & Neurology | 3815 Pelham St, Dearborn, MI 48124-3852 | 2012-12-03 |
| 1386973733 | Rana Rkein | Physician Assistant | 3815 Pelham St, Dearborn, MI 48124-3852 | 2009-12-14 |
| 1629305685 | Hyun S Chang M D P C | Surgery | 3815 Pelham St, Suite 5, Dearborn, MI 48124-3852 | 2009-11-12 |
| 1831357466 | James D. Gerard D.d.s. & A. Marla Gerard D.d.s., P.c | Dentist | 3815 Pelham St, Suite 11, Dearborn, MI 48124-3852 | 2008-05-30 |
| 1104090083 | Andrew L. Marcus, M.d.,p.c. | Psychiatry & Neurology | 3815 Pelham St, Suite 14, Dearborn, MI 48124-3852 | 2008-04-22 |
| Find all providers in the same location | ||||
| 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 | 1835P1300X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| Specialization | Psychiatric |
| A licensed pharmacist who has demonstrated specialized knowledge and skill in optimizing care of patients with psychiatric illness by assessing and monitoring patients, recognizing drug-induced problems, and recommending appropriate treatment plans. |
| Notes: Source: Specialty certification and recertification program administered by Board of Pharmaceutical Specialties, www.bpsweb.org [7/1/2006: modified title, added definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801323316 | Anthony Larouche | Pharmacist | 500 Hancock St Ste 100, Saginaw, MI 48602-4224 | 2017-05-15 |
| 1285177493 | Opal M Bacon | Pharmacist | 1 Ford Place, 1c, Outpatient Psychiatry, Detroit, MI 48202 | 2016-11-21 |
| 1457437873 | Patricia Jane Jones | Pharmacist | 2676 Dorchester Rd, Birmingham, MI 48009-5989 | 2006-10-27 |
| 1053313973 | Richard Charles Bercou | Pharmacist | 23025 Old Orchard Trl, Bingham Farms, MI 48025-3432 | 2005-08-11 |
| 1871101394 | Cherisse Norberte | Pharmacist | 325 E H St, Iron Mountain, MI 49801-4760 | 2020-07-21 |
| 1255984233 | Andrew Saul | Pharmacist | 1500 Weiss St, Saginaw, MI 48602-5251 | 2019-07-19 |
| 1336551738 | Ferdnand Chisom Osuagwu | Pharmacist | 1000 Houghton Ave, Saginaw, MI 48602-5303 | 2014-05-20 |
| 1952734923 | Chelsea N Clark | Pharmacist | 5500 Armstrong Rd, 119a, Battle Creek, MI 49037-7314 | 2013-08-14 |
| 1609130640 | Shruti Chopra | Pharmacist | 5500 Armstrong Rd, Vamc Pharmacy -119a, Battle Creek, MI 49037-7314 | 2012-06-25 |
| 1669695987 | Kimberly Ann Hedrich | Pharmacist | 1200 N West Ave, Suite 500, Jackson, MI 49202-2179 | 2007-04-11 |
| Find all providers with the same taxonomy | ||||
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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.