Provider Demographics
NPI:1386049724
Name:HABHAB, NADIA (PHD)
Entity type:Individual
Prefix:MS
First Name:NADIA
Middle Name:
Last Name:HABHAB
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26400 LAHSER RD STE 220
Mailing Address - Street 2:
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48033-2674
Mailing Address - Country:US
Mailing Address - Phone:248-354-8460
Mailing Address - Fax:
Practice Address - Street 1:165 CLAREMONT ST
Practice Address - Street 2:
Practice Address - City:DEARBORN
Practice Address - State:MI
Practice Address - Zip Code:48124-1305
Practice Address - Country:US
Practice Address - Phone:313-500-2368
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-28
Last Update Date:2024-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301015509103TC1900X
MI6301019088103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI3434247Medicaid