Provider Demographics
NPI:1174925630
Name:NIDA HAMID PSYD PLLC
Entity type:Organization
Organization Name:NIDA HAMID PSYD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:NIDA
Authorized Official - Middle Name:H
Authorized Official - Last Name:HAMID
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:248-385-5756
Mailing Address - Street 1:3155 W BIG BEAVER RD STE 109
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48084-3006
Mailing Address - Country:US
Mailing Address - Phone:248-385-5756
Mailing Address - Fax:248-385-5758
Practice Address - Street 1:3155 W BIG BEAVER RD STE 109
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:MI
Practice Address - Zip Code:48084-3006
Practice Address - Country:US
Practice Address - Phone:248-878-0925
Practice Address - Fax:248-644-0237
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-16
Last Update Date:2020-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301014942103TC0700X, 103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103G00000XBehavioral Health & Social Service ProvidersClinical NeuropsychologistGroup - Multi-Specialty
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty