Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Modern Psych and Wellness PLLC

Organization Psychologist · NPI 1104674621

Modern Psych and Wellness PLLC is a Psychologist in Taylor, Michigan. Registered with an NPI since 2024.

In the registry since
2024
Specialties on file
4
What do these letters mean?
PLLC — Professional limited liability company
A form of business registration, not a clinical qualification.

See every abbreviation used in this directory →

Practice location Address checks out

21415 Goddard Rd
Taylor, MI 48180-4247
Phone: (313) 737-0023
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Psychologist (primary) Taxonomy 103T00000X
Addiction (Substance Use Disorder) Psychologist Taxonomy 103TA0400X
Internal Medicine Physician Taxonomy 207R00000X
Psychiatry Physician Taxonomy 2084P0800X

Record details

NPI number1104674621
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Rana Succurro — Owner · (248) 667-8014
NPI enumeratedMay 9, 2024
Last updated in NPPESMarch 18, 2025
Certification dateMarch 18, 2025
Mailing address21415 Goddard Rd, Taylor, MI 48180-4247

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