TARA DANIELLE WIDAK (NPI# 1669849881) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1669849881 |
| Entity Type | Individual |
| Full Name | TARA DANIELLE WIDAK |
| Credential | LLPC |
| Practice Address |
751 E Grand Blvd Detroit MI 48207-2529 |
| Practice Telephone | 3139222222 |
| Mailing Telephone | 3139222222 |
| Enumeration Date | 2015-08-24 |
| Last Update Date | 2015-08-24 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YP2500X |
Counselor Specialization: Professional |
6401014946 | MI | Behavioral Health & Social Service Providers |
| Street Address |
751 E GRAND BLVD |
| City | DETROIT |
| State | MI |
| Zip Code | 48207-2529 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700984341 | Quality Behavorial Health Inc. | Substance Abuse Rehabilitation Facility | 751 E Grand Blvd, Detroit, MI 48207-2529 | 2006-09-20 |
| 1609407311 | Marissa Osinski | Peer Specialist | 751 E Grand Blvd, Detroit, MI 48207-2529 | 2020-01-31 |
| 1821560145 | Sheniva Sanders | Social Worker | 751 E Grand Blvd, Detroit, MI 48207-2529 | 2018-12-27 |
| 1578068896 | Channell Loraine Johnson | Counselor | 751 E Grand Blvd, Detroit, MI 48207-2529 | 2018-03-28 |
| 1770081242 | Joya Monnett Loray Nunn | Counselor | 751 E Grand Blvd, Detroit, MI 48207-2529 | 2018-01-30 |
| 1699283234 | Karen Stanford | Registered Nurse | 751 E Grand Blvd, Detroit, MI 48207-2529 | 2018-01-17 |
| 1730697830 | Jamie Wood | Registered Nurse | 751 E Grand Blvd, Detroit, MI 48207-2529 | 2018-01-11 |
| 1790292670 | Beverly Bunton | Licensed Practical Nurse | 751 E Grand Blvd, Detroit, MI 48207-2529 | 2018-01-02 |
| 1427564921 | Christina Byrd | Licensed Practical Nurse | 751 E Grand Blvd, Detroit, MI 48207-2529 | 2017-12-19 |
| 1407371529 | Kymaletha Rochelle Brown | Counselor | 751 E Grand Blvd, Detroit, MI 48207-2529 | 2017-08-09 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245848506 | Anton R Gonzales | Physical Therapy Assistant | 2295 Chene, Detroit, Mi 48207, Detroit, MI 48207 | 2020-07-22 |
| 1033733928 | Taleshia Moss | Occupational Therapist | 2295 Chene, Detroit, MI 48207 | 2020-06-05 |
| 1942858550 | Ronald Royce Cochran | Counselor | 2925 Russell St, Detroit, Detroit, MI 48207 | 2019-08-27 |
| 1649831439 | Charday Penick | Social Worker | Team Wellness, 2925 Russell St, Detroit, MI 48207 | 2019-06-24 |
| 1568023349 | Alphia Ramona Burgess | Social Worker | Team Wellness Center, 2925 Russell Street, Detroit, MI 48207 | 2019-06-24 |
| 1447741608 | Sherice Ward | Social Worker | 100 River Place Drive, Ste 250, Detroit, MI 48207 | 2018-05-23 |
| 1427549955 | Mission Point of Detroit, LLC | Skilled Nursing Facility | 2102 Orleans, Detroit, MI 48207 | 2018-05-21 |
| 1043723737 | Olivia Carter | Case Management | 2712 Gratiot, Detroit, MI 48207 | 2017-11-16 |
| 1558885590 | Kalimah Johnson | Social Worker | 701 Mcdougall, Detroit, MI 48207 | 2017-08-01 |
| 1922534692 | Angela Young | Social Worker | 100 River Place 520, Detroit, MI 48207 | 2017-05-02 |
| Find all providers in zip 48207 | ||||
| Taxonomy Code | 101YP2500X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Professional |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285244731 | Better Days Counseling, Pllc | Counselor | 13501 Schaefer Hwy, Detroit, MI 48227-3538 | 2020-08-08 |
| 1174144281 | Jasmine Noble | Counselor | 1535 Franklin St Apt 201, Detroit, MI 48207-4056 | 2020-04-29 |
| 1306473145 | Julie Weatherhead | Counselor | 1624 Estates Dr, Detroit, MI 48206-2814 | 2020-03-23 |
| 1972134591 | Tanya Bankston | Counselor | 4221 Moran St, Detroit, MI 48207-1705 | 2020-02-01 |
| 1871124768 | Andrew Todd Henderson | Counselor | 1 Detroit Metro Airport, Detroit, MI 48242-1004 | 2020-01-29 |
| 1922561059 | Odis Bellinger | Counselor | 440 Burroughs St Ste 149, Detroit, MI 48202-3429 | 2019-04-06 |
| 1245799469 | Zipporah K Bolar Sr. | Counselor | 2900 Conner St Bldg A, Detroit, MI 48215-2407 | 2019-03-18 |
| 1215493549 | Sammie Edwards | Counselor | 15734 Sussex St, Detroit, MI 48227 | 2019-02-12 |
| 1942764329 | Crystal Jean Oliver | Counselor | 13770 Mecca St., Detroit, MI 48227-3025 | 2019-01-30 |
| 1922577246 | Sheila Marie Cheeks | Counselor | 1600 Pingree St, Detroit, MI 48206-2436 | 2018-11-15 |
| Find all providers in DETROIT | ||||
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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.