TBCI PC (NPI# 1285705095) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1285705095 |
| Entity Type | Organization |
| Organization Name | TBCI PC |
| Other Organization Name | TRAUMATIC BRAIN AND CATASTROPHIC INJURY PC |
| Practice Address |
1059 Owendale Troy MI 48083 |
| Practice Telephone | 2485260110 |
| Practice Fax Number | 2486809138 |
| Mailing Telephone | 2485260110 |
| Mailing Fax Number | 2486809138 |
| Enumeration Date | 2006-11-13 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. THOMAS J PARK (MEDICAL DIRECTOR) |
| Authorized Official Telephone | 2485260110 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| X | 103T00000X | Psychologist | Behavioral Health & Social Service Providers | ||
| X | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
Allopathic & Osteopathic Physicians | ||
| X | 225100000X | Physical Therapist | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | ||
| X | 225400000X | Rehabilitation Practitioner | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | ||
| X | 225X00000X | Occupational Therapist | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | ||
| X | 235Z00000X | Speech-Language Pathologist | Speech, Language and Hearing Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | BLUE CROSS | 30421 | 01 |
| Other Name | Type Code |
|---|---|
| Traumatic Brain and Catastrophic Injury PC | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437228798 | Tbci PC | Rehabilitation Practitioner | 1059 Owendale, Troy, MI 48083 | 2006-11-08 |
| Street Address |
1059 OWENDALE |
| City | TROY |
| State | MI |
| Zip Code | 48083 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437228798 | Tbci PC | Rehabilitation Practitioner | 1059 Owendale, Troy, MI 48083 | 2006-11-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417420449 | Thapasvi Muttirevula | Physical Therapist | 2422 Cedar Knoll Dr, Troy, MI 48083 | 2019-01-02 |
| 1114418290 | Ann Katchke | Physical Therapist | 3179 Livernois Rd, Troy, MI 48083 | 2018-05-23 |
| 1518485945 | Risa Rae Mendelson | Counselor | 1059 Owendale Street, Troy, MI 48083 | 2017-09-06 |
| 1497277115 | Gassan Asadi | Pharmacist | 215 E Big Beaver Rd Ste 500, Troy, MI 48083 | 2017-07-14 |
| 1528510328 | Dylan Skye Polasko | Behavioral Analyst | 2221 E 4th St, #101, Troy, MI 48083 | 2016-10-27 |
| 1235683061 | Sadia Ghazi | Technician, Other | 3178 Daley Dr., Troy, MI 48083 | 2016-08-10 |
| 1548664345 | Amber Leigh Ernst | Social Worker | 1225 E. Big Beaver Road, Troy, MI 48083 | 2014-10-22 |
| 1356782411 | Michelle Louise Knoblock | Nurse Anesthetist, Certified Registered | 1560 E Maple Rd Ste 100, Troy, MI 48083 | 2013-07-17 |
| 1437400728 | Oakland Physicians Surgery Center | Clinic/Center | 1560 E. Maple Road, Suite 100, Troy, MI 48083 | 2012-09-26 |
| 1861748238 | Pro Med Substance Abuse Program LLC | Psychologist | 2891 E. Maple Rd. Suite 200, Troy, MI 48083 | 2012-08-03 |
| Find all providers in zip 48083 | ||||
| Taxonomy Code | 103T00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public. |
| Notes: Source: American Psychological Association [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568943181 | Kristen Ghersi Hurrell | Psychologist | 3725 Rochester Rd, Troy, MI 48083-5244 | 2018-08-22 |
| 1225578214 | Casey Michelle Bazarewski | Psychologist | 5115 Babbit Dr, Troy, MI 48085-3448 | 2017-02-24 |
| 1902268402 | Michael Pignatiello | Psychologist | 1314 Windy Hill Ct, Troy, OH 45373-4572 | 2016-03-23 |
| 1932442829 | Jasmin Patel | Psychologist | 416 Evaline Dr, Troy, MI 48085-5509 | 2013-03-29 |
| 1851690721 | Melissa Kandah | Psychologist | 2221 Livernois Rd Ste 101, Troy, MI 48083-1603 | 2011-03-17 |
| 1205134525 | Michigan Behavioral Medicine | Psychologist | 625 E Big Beaver Road, Suite 101, Troy, MI 48083 | 2011-03-10 |
| 1710282611 | Marcie Wagner | Psychologist | 4780 Orchard Ridge Dr, Troy, MI 48098-4121 | 2011-01-24 |
| 1093832818 | James Wargel | Psychologist | 200 East Big Beaver Rd, Troy, MI 48083-1208 | 2007-03-25 |
| 1427197409 | James Clifford Kors | Psychologist | 2075 West Big Beaver, Suite 520, Troy, MI 48084 | 2007-02-06 |
| 1801949391 | John Thomas Lynch IIi | Psychologist | 3336 Essex Dr, Troy, MI 48084-2705 | 2007-01-19 |
| Find all providers in TROY | ||||
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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.