GEODES, ANXIETY AND TRAUMA CLINIC, LLC (NPI# 1861876468) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1861876468 |
| Entity Type | Organization |
| Organization Name | GEODES, ANXIETY AND TRAUMA CLINIC, LLC |
| Practice Address |
1164 James Savage Rd Ste E Midland MI 48640-6843 |
| Practice Telephone | 9895135107 |
| Practice Fax Number | 8554839638 |
| Mailing Telephone | 9895135107 |
| Mailing Fax Number | 8554839638 |
| Enumeration Date | 2015-07-13 |
| Last Update Date | 2015-08-11 |
| Authorized Official Name | NICOLE LYNETTE BOURLAKAS-MAURER (OWNER, CLINICAL SOCIAL WORKER) |
| Authorized Official Telephone | 9895135107 |
| Authorized Official Credential | LMSW, CBIS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1041C0700X |
Social Worker Specialization: Clinical |
6801085334 | MI | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | 730195 | 05 |
| Street Address |
1164 JAMES SAVAGE RD STE E |
| City | MIDLAND |
| State | MI |
| Zip Code | 48640-6843 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407481260 | Sdpa Management Pllc | Dentist | 4915 Jefferson Ave., Midland, MI 48640 | 2020-03-11 |
| 1598237364 | Michelle Marie Arthur | Occupational Therapist | 3007 North Saginaw Rd, Midland, MI 48640 | 2018-12-18 |
| 1295202349 | Personal Assistance Options | Private Vehicle | 1509 Washington Street, Suite C, Midland, MI 48640 | 2018-10-26 |
| 1972094720 | Ashley E Cline | Technician, Other | 5405 Oakridge Dr., Midland, MI 48640 | 2018-05-27 |
| 1669963898 | Hope Richelle Walker | Social Worker | 396 S 9 Mile Rd, Midland, MI 48640 | 2018-05-23 |
| 1568964807 | David Isaac Bearss | Physical Therapist | 4401 Campus Ridge Drive, Suite 1000, Midland, MI 48640 | 2018-03-02 |
| 1295237741 | Ashley Michelle Ghose | Physical Therapist | 4401 Campus Ridge Drive Suite 1000, Midland, MI 48640 | 2018-03-01 |
| 1801306055 | Elizabeth Diana Dickerson | Social Worker | 218 Fast Lane Drive, Midland, MI 48640 | 2017-10-02 |
| 1528502275 | Sheila Jensen | Behavior Technician | 248 E Dopp Rd, Midland, MI 48640 | 2016-12-15 |
| 1518328657 | Becky Staudacher | Technician, Other | 707 Mill St, Midland, MI 48640 | 2016-03-17 |
| Find all providers in zip 48640 | ||||
| Taxonomy Code | 1041C0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Social Worker |
| Specialization | Clinical |
| A social worker who holds a master’s or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master’s supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances. |
| Notes: Source: National Association of Social Workers, 2008 [7/1/2009: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831796499 | Stacey Lynn-churchill Smyczynski | Social Worker | 1511 W Carpenter St, Midland, MI 48640-4339 | 2020-10-07 |
| 1457907172 | Robin Lynn Greiner | Social Worker | 4710 N Saginaw Rd Ste B, Midland, MI 48640-2300 | 2019-08-18 |
| 1194385633 | Kelley Susan Wiese | Social Worker | 612 Corvus Dr, Midland, MI 48642-8111 | 2019-06-17 |
| 1164926689 | Sarah Meinzer | Social Worker | 3500 N A St Ste 2400, Midland, TX 79705-3610 | 2018-03-20 |
| 1659888329 | Jessica Lynn Vanhorn | Social Worker | 220 W Main St Ste 104, Midland, MI 48640-5184 | 2018-01-04 |
| 1235587270 | Angelique Rinearson | Social Worker | 5103 Eastman Ave Ste 173, Midland, MI 48640-6795 | 2016-06-01 |
| 1770941130 | Samantha Jammer | Social Worker | 6 W Wyllys Ct, Midland, MI 48642-4618 | 2016-02-01 |
| 1962817080 | Rebecka Suzane Hale | Social Worker | 1194 Meadowlark, Midland, MI 48640-7619 | 2014-06-26 |
| 1972920569 | Donna Alice Clark | Social Worker | 3007 N. Saginaw Rd., Midmichigan Home Care, Midland, MI 48640 | 2014-03-21 |
| 1477979987 | Lisa Jo Ciaciuch | Social Worker | 1714 Eastman Avenue, Midland, MI 48640 | 2014-03-07 |
| Find all providers in MIDLAND | ||||
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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.