SOUTHFIELD MENTAL HEALTH ASSOCIATES PC
NPI 1619015872
Clinic/Center - Mental Health (Including Community Mental Health Center) in Southfield, MI
About Southfield Mental Health Associates Pc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
SOUTHFIELD MENTAL HEALTH ASSOCIATES PC (NPI 1619015872) is a healthcare organization registered as a mental health (including community mental health center) in Southfield, Michigan and active in the NPI registry since February 2007. The organization lists Lawrence J Gusman, Owner President, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 2
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Southfield Mental Health Associates Pc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Revalidation Due Date
Revalidation due by October 31, 2026
Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.
Clinicians Billing Medicare Through This Organization
12Medicare enrollment records show 12 clinicians reassign Medicare billing to Southfield Mental Health Associates PC, which bills Medicare for the services they deliver. Of these, 6 practice at this address and 9 within 10 miles. They are listed nearest first.
Clinicians by Medicare Specialty 5
Clinicians, nearest first (12)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Southfield Mental Health Associates PC's NPI number?
The NPI number for Southfield Mental Health Associates PC is 1619015872. It was assigned to this organization in the NPPES registry on February 1, 2007.
Where is Southfield Mental Health Associates PC located?
Southfield Mental Health Associates PC is located at 17320 W 12 Mile Rd Suite 101, Southfield, MI 48076. The listed phone number is (248) 557-3606.
What is Southfield Mental Health Associates PC's specialty?
The primary specialty registered for this NPI is Clinic/Center, specializing in Mental Health (Including Community Mental Health Center), with taxonomy code 261QM0801X.
Is Southfield Mental Health Associates PC enrolled in Medicare?
Yes. Southfield Mental Health Associates PC is registered in the Medicare PECOS enrollment system.
When is Southfield Mental Health Associates PC's Medicare revalidation due?
According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (Michigan, Clinic/Group Practice) is due for revalidation by October 31, 2026. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.
How many clinicians bill Medicare through Southfield Mental Health Associates PC?
According to the CMS Revalidation Reassignment List (October 2026 release), 12 clinicians in 5 Medicare specialties reassign their Medicare billing to Southfield Mental Health Associates PC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Clinical Social Worker (6), Mental Health Counselor (2) and Nurse Practitioner (2). Of these, 6 practice at this address and 9 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
What insurance does Southfield Mental Health Associates PC accept?
Health plans from Blue Care Network of Michigan and Blue Cross Blue Shield of Michigan Mutual Insurance Company list Southfield Mental Health Associates PC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Southfield Mental Health Associates PC was last updated on August 22, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Southfield Mental Health Associates Pc · NPI 1619015872
Mental Health (Including Community Mental Health Center) organization in Southfield, Michigan. Organization record, active in the CMS NPPES registry since February 1, 2007.
## Identity
- **NPI:** 1619015872 (Entity type: Organization)
- **Enumerated:** February 1, 2007
- **Primary specialty:** Clinic/Center - Mental Health (Including Community Mental Health Center) · taxonomy 261QM0801X
- **Organization subpart:** No
- **Authorized official:** Lawrence Gusman, OWNER PRESIDENT
## Practice location
- **Address:** 17320 W 12 MILE RD, SUITE 101, Southfield, MI 48076-2102
- **Phone:** (248) 557-3606 · **Fax:** (248) 557-4697
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Medicare revalidation due:** October 31, 2026 (Non-DME Part B, Michigan, Clinic/Group Practice) · CMS Revalidation Due Date List, October 2026 release
- **Clinicians billing through this organization:** 12 clinicians in 5 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Clinical Social Worker (6), Mental Health Counselor (2), Nurse Practitioner (2); 6 practice at this address and 9 within 10 miles · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** August 22, 2020
- **Other identifiers:** Other 302643 (MI); Other 7509106210 (MI)
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Source: [NPI Profile](https://npiprofile.com/npi/1619015872) · Data from the CMS NPPES public registry.