Provider Demographics
NPI:1437961513
Name:MY MENTAL WELLNESS, INC
Entity type:Organization
Organization Name:MY MENTAL WELLNESS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINIC DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:DANISH
Authorized Official - Middle Name:SYED
Authorized Official - Last Name:HASAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:313-584-4143
Mailing Address - Street 1:14350 TIREMAN ST
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48228-6100
Mailing Address - Country:US
Mailing Address - Phone:313-584-4143
Mailing Address - Fax:
Practice Address - Street 1:14350 TIREMAN ST
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48228-6100
Practice Address - Country:US
Practice Address - Phone:313-584-4143
Practice Address - Fax:313-914-7187
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-24
Last Update Date:2025-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No251V00000XAgenciesVoluntary or Charitable
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No251K00000XAgenciesPublic Health or Welfare