TRAVERSE HEALTH CLINIC AND COALITION (NPI# 1790276822) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790276822 |
| Entity Type | Organization |
| Organization Name | TRAVERSE HEALTH CLINIC AND COALITION |
| Other Organization Name | TRAVERSE HEALTH CLINIC AND COALITION MSU TELE-PSYCH SERVICES |
| Practice Address |
East Fee Hall 965 Fee Road, Room A222 East Lansing MI 48824 |
| Mailing Address |
1719 S Garfield Ave Traverse City MI 49686-4337 |
| Practice Telephone | 5173534362 |
| Mailing Telephone | 2319350799 |
| Mailing Fax Number | 2319350962 |
| Enumeration Date | 2018-05-24 |
| Last Update Date | 2018-05-24 |
| Authorized Official Name | ARLENE JOSEPHINE BRENNAN (CEO) |
| Authorized Official Telephone | 2319350799 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Traverse Health Clinic and Coalition MSU Tele-Psych Services | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407309685 | Traverse Health Clinic and Coalition | Clinic/Center | 1719 S Garfield Ave, Traverse City, MI 49686-4337 | 2016-07-25 |
| 1417322884 | Traverse Health Clinic and Coalition | Clinic/Center | 105 Hall St, Traverse City, MI 49684-2288 | 2015-12-10 |
| 1467632059 | Traverse Health Clinic and Coalition | Clinic/Center | 3147 Logan Valley Rd, Traverse City, MI 49684-4772 | 2007-11-12 |
| Street Address |
EAST FEE HALL 965 FEE ROAD, ROOM A222 |
| City | EAST LANSING |
| State | MI |
| Zip Code | 48824 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528680303 | Emilia Elizabeth Mattioli | Psychiatry & Neurology | 965 Fee Road Room A223, East Lansing, MI 48824 | 2020-05-14 |
| 1447871983 | James O'brien | Psychiatry & Neurology | Msu Psychiatry Residency Program, 965 Fee Road, Room A233, East Lansing, MI 48824 | 2020-05-06 |
| 1750916979 | Mulin Xiong | Student in an Organized Health Care Education/Training Program | 965 Wilson Road Suite A110, East Fee Hall, East Lansing, MI 48824 | 2020-03-09 |
| 1821659301 | Tovah Apolonia Aho | Psychiatry & Neurology | Michigan State University Psychiatric Residency, 965 Fee Road, Room A233, East Lansing, MI 48824 | 2019-06-25 |
| 1912564881 | Asmara Theresa Hoo | Psychiatry & Neurology | 965 Fee Road, Room A233, East Lansing, MI 48824 | 2019-05-24 |
| 1922598515 | Jubin Joseph Cheruvelil | Specialist/Technologist, Other | 446 W. Circle Dr. Room 249 Annex, Justin S. Morrill Hall of Agriculture, East Lansing, MI 48824 | 2018-05-18 |
| 1073003257 | Dawn Arvye Contreras | Health Educator | 446 West Circle Dr., Justin S. Morrill Hall of Agriculture, Room 166, East Lansing, MI 48824 | 2018-05-14 |
| 1710406046 | Kimberly Ann Breukink | Social Worker | 463 East Circle Drive, Michigan State University, Counseling and Psychiatric Services, East Lansing, MI 48824 | 2017-09-19 |
| 1043766314 | Ahmed Jouan | Psychiatry & Neurology | 804 Service Rd A217, East Lansing, MI 48824 | 2016-08-28 |
| 1154760312 | Samantha Fugate Kennedy | Psychiatry & Neurology | 909 Fee Rd Ste B119, East Lansing, MI 48824 | 2013-06-21 |
| Find all providers in zip 48824 | ||||
| Taxonomy Code | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
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| 1053948265 | Upper Great Lakes Family Health Center | Clinic/Center | 1414 W Fair Ave Ste 242, Marquette, MI 49855-5406 | 2020-03-26 |
| 1568096923 | Grace Health, Inc. | Clinic/Center | 825 Capital Ave Ne, Battle Creek, MI 49017-5605 | 2020-02-25 |
| Find all providers with the same taxonomy | ||||
| City | EAST LANSING |
| Zip Code | 48824 |
Please comment or provide details below to improve the information on TRAVERSE HEALTH CLINIC AND COALITION.
| 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.