Healthcare Provider Details
I. General information
NPI: 1962357574
Provider Name (Legal Business Name): NUVERA MIND PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/27/2026
Last Update Date: 03/12/2026
Certification Date: 03/12/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
6570 CASTLE DR
BLOOMFIELD HILLS MI
48301-2907
US
IV. Provider business mailing address
PO BOX 250011
FRANKLIN MI
48025-0011
US
V. Phone/Fax
- Phone: 313-574-7597
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QM0801X |
| Taxonomy | Mental Health Clinic/Center (Including Community Mental Health Center) |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 103TH0100X |
| Taxonomy | Health Service Psychologist |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 103TH0004X |
| Taxonomy | Health Psychologist |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103TC0700X |
| Taxonomy | Clinical Psychologist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
CHRISTOPHER
T
CORBIN
Title or Position: CLINICAL PSYCHOLOGIST /OWNER
Credential: PSYD
Phone: 313-574-7597