Michigan Modern Psychology Group,pllc
NPI 1447701255ActiveOrganization· Psychologist, Clinical· Dearborn, MI
Psychologist, Clinical in Dearborn, Michigan, registered in NPPES in October 2016. The authorized official on file is Manuel A. Manrique, PHD, Director. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1447701255 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Oct 17, 2016 |
| Last updated in NPPES | May 29, 2024 |
| Certified by provider | May 29, 2024 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Psychologist, Clinical Primary | 103TC0700X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (MI) |
|---|
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