GREAT LAKES TELETHERAPY (NPI# 1174139968) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174139968 |
| Entity Type | Organization |
| Organization Name | GREAT LAKES TELETHERAPY |
| Practice Address |
707 W Liberty St Ann Arbor MI 48103-4348 |
| Practice Telephone | 7342243773 |
| Mailing Telephone | 7342243773 |
| Enumeration Date | 2020-09-17 |
| Last Update Date | 2020-09-17 |
| Authorized Official Name | MRS. LEAH R BROCK (PSYCHOTHERAPIST) |
| Authorized Official Telephone | 7342243773 |
| Authorized Official Credential | LMSW |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251S00000X | Community/Behavioral Health | Agencies |
| Street Address |
707 W LIBERTY ST |
| City | ANN ARBOR |
| State | MI |
| Zip Code | 48103-4348 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043839343 | Melissa Sylvia Danan Rilko | Social Worker | 1775 Timber Trail, Ann Arbor, MI 48103 | 2020-04-16 |
| 1427602929 | Ashwini Gulwadi, Pllc | Psychiatry & Neurology | 2100 S Main Street, Suite A, Unit 4, Ann Arbor, MI 48103 | 2019-08-01 |
| 1225593155 | Brent Aaron Reeve | Chiropractor | 203 S. Zeeb Rd., Suite 106, Ann Arbor, MI 48103 | 2019-02-05 |
| 1548746779 | Loren Camano Shkolnik | Registered Nurse | 3200 W Liberty Rd Ste C5, Ann Arbor, MI 48103 | 2018-07-11 |
| 1982193256 | Jacob B Nienhuis | Psychologist | 4488 Jackson Rd Ste 7b, Ann Arbor, MI 48103 | 2018-05-02 |
| 1053818633 | Regents of The University of Michigan | Eyewear Supplier (Equipment, not the service) | 380 Parkland Plz Ste 210, Ann Arbor, MI 48103 | 2018-04-10 |
| 1376052647 | Shivika Verma | Dentist | 3071 Signature Blvd, Apartment #f, Ann Arbor, MI 48103 | 2017-09-29 |
| 1881118206 | Harrison Udensi Igwe | Clinic/Center | 522 South Maple Stree, Ann Arbor, MI 48103 | 2017-07-27 |
| 1841727641 | Kathleen Murphy | Psychologist | 4141 Woodland Drive, Ann Arbor, MI 48103 | 2017-05-11 |
| 1972037133 | Jonathan Broek | Dietitian, Registered | 2920 Lakeview Dr, Ann Arbor, MI 48103 | 2017-04-14 |
| Find all providers in zip 48103 | ||||
| Taxonomy Code | 251S00000X |
| Grouping | Agencies |
| Classification | Community/Behavioral Health |
| A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, mental retardation, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. |
| Notes: Source: National Medicaid EDI HIPAA NPI Sub Work Group [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467096297 | Reflection Counseling Services Pllc | Community/Behavioral Health | 2227 Packard St Ste 2, Ann Arbor, MI 48104-6394 | 2019-11-05 |
| 1225693674 | Andrea Broadwater Counseling and Consulting, LLC | Community/Behavioral Health | 326 W Liberty St Ste 3, Ann Arbor, MI 48103-4341 | 2019-05-01 |
| 1326504804 | Krista Gravatt Lmsw, LLC | Community/Behavioral Health | 455 E Eisenhower Pkwy Ste 30, Ann Arbor, MI 48108-3304 | 2019-02-20 |
| 1982169538 | Eventually LLC | Community/Behavioral Health | 455 E Eisenhower Pkwy Ste 300, Ann Arbor, MI 48108-3324 | 2019-02-07 |
| 1235678806 | Heather Herrick, Lmsw, Pllc | Community/Behavioral Health | 2311 Shelby Ave Ste 101d, Ann Arbor, MI 48103-3849 | 2017-02-15 |
| 1942657689 | Amazing Grace Counseling Outreach | Community/Behavioral Health | 2035 Hogback Rd # 204, Ann Arbor, MI 48105-9732 | 2016-05-23 |
| 1639544646 | Danielle Aimone | Community/Behavioral Health | 404 Snyder Ave, Ann Arbor, MI 48103-5551 | 2015-12-02 |
| 1780082883 | Kari J Schmidt, Lpc, Ncc, Rpt-s | Community/Behavioral Health | 1785 W Stadium Blvd Ste 201b, Ann Arbor, MI 48103-5285 | 2014-12-05 |
| 1346671880 | Community Mental Health Partnership of Southeast Michigan | Community/Behavioral Health | 3005 Boardwalk St Ste 200, Ann Arbor, MI 48108-5218 | 2013-12-10 |
| 1699010405 | Carroll Care Management LLC | Community/Behavioral Health | 2005 Audubon Dr, Ann Arbor, MI 48103-6183 | 2012-12-05 |
| Find all providers in ANN ARBOR | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.