GOGEBIC COUNTY COMMUNITY MENTAL HEALTH AUTHORITY (NPI# 1912957143) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912957143 |
| Entity Type | Organization |
| Organization Name | GOGEBIC COUNTY COMMUNITY MENTAL HEALTH AUTHORITY |
| Other Organization Name | GOGEBIC COUNTY COMMUNITY MENTAL HEALTH |
| Practice Address |
103 W Us Highway 2 Wakefield MI 49968-9515 |
| Practice Telephone | 9062296100 |
| Practice Fax Number | 9062296191 |
| Mailing Telephone | 9062296100 |
| Mailing Fax Number | 9062296191 |
| Enumeration Date | 2006-05-10 |
| Last Update Date | 2015-10-27 |
| Authorized Official Name | MRS. JULIE HAUTALA (C.E.O.) |
| Authorized Official Telephone | 9062296100 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 103TC2200X |
Psychologist Specialization: Clinical Child & Adolescent |
Behavioral Health & Social Service Providers | ||
| N | 103T00000X | Psychologist | Behavioral Health & Social Service Providers | ||
| N | 104100000X | Social Worker | Behavioral Health & Social Service Providers | ||
| N | 1041C0700X |
Social Worker Specialization: Clinical |
Behavioral Health & Social Service Providers | ||
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | BLUE CROSS OPC | 750910818 | 01 |
| MI | MAGELLAN STATE OF MI GROU | IG027143 | 01 |
| MI | 1708119 | 05 | |
| MI | 4351265 | 05 |
| Other Name | Type Code |
|---|---|
| Gogebic County Community Mental Health | Former Legal Business Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396396180 | Gogebic County Community Mental Health Authority | Clinic/Center | 103 W Us Highway 2, Wakefield, MI 49968-9515 | 2019-09-24 |
| Street Address |
103 W US HIGHWAY 2 |
| City | WAKEFIELD |
| State | MI |
| Zip Code | 49968-9515 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396359048 | Jenna Fingeroos | Social Worker | 103 W Us Highway 2, Wakefield, MI 49968-9515 | 2020-09-01 |
| 1760013460 | Kristina Leeann Potesta | Case Manager/Care Coordinator | 103 W Us Highway 2, Wakefield, MI 49968-9515 | 2020-01-31 |
| 1568092500 | Miranda Anderson | Case Manager/Care Coordinator | 103 W Us Highway 2, Wakefield, MI 49968-9515 | 2020-01-17 |
| 1396396180 | Gogebic County Community Mental Health Authority | Clinic/Center | 103 W Us Highway 2, Wakefield, MI 49968-9515 | 2019-09-24 |
| 1144879636 | Lew Laukka | Registered Nurse | 103 W Us Highway 2, Wakefield, MI 49968-9515 | 2019-09-06 |
| 1417445982 | Kenneth Hansen | Social Worker | 103 W Us Highway 2, Wakefield, MI 49968-9515 | 2018-04-30 |
| 1548776081 | Daniel Peter Tibaldo | Social Worker | 103 W Us Highway 2, Wakefield, MI 49968-9515 | 2017-12-20 |
| 1194231035 | Leah Ruth Nikula | Social Worker | 103 W Us Highway 2, Wakefield, MI 49968-9515 | 2017-12-14 |
| 1942715867 | Laurie Ann Niemi | Social Worker | 103 W Us Highway 2, Wakefield, MI 49968-9515 | 2017-12-14 |
| 1215442140 | Richard Jay Maher | Social Worker | 103 W Us Highway 2, Wakefield, MI 49968-9515 | 2017-12-14 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881085017 | Gina Cummings | Registered Nurse | 103 W Us2, Wakefield, MI 49968 | 2015-02-10 |
| 1790906675 | Robert Wester Aukee | Dentist | 411 Brotherton St, Wakefield, MI 49968 | 2007-05-01 |
| 1508925884 | William Smith Malloy Jr. | Social Worker | 103 West U.S. 2, Wakefield, MI 49968 | 2006-12-06 |
| 1124239975 | Diane Frances Hill | Counselor | 103 West U.S. 2, Wakefield, MI 49968 | 2007-05-24 |
| 1447467311 | Barbra B Braithwaite | Psychologist | 103 West U.S. 2, Wakefield, MI 49968 | 2007-05-17 |
| 1346457363 | Michael D Rubatt | Counselor | 103 West U.S. 2, Wakefield, MI 49968 | 2007-05-17 |
| 1932277407 | Michael J Gregor | Dentist | 606 Putnam St, Wakefield, MI 49968-1024 | 2006-12-01 |
| 1164661708 | Laura Ann Novascone | Registered Nurse | 407 Brotherton St, Wakefield, MI 49968-1326 | 2009-02-04 |
| 1427297001 | Scott D Novascone | Registered Nurse | 407 Brotherton St, Wakefield, MI 49968-1326 | 2009-02-05 |
| 1528073145 | Wakefield Pharmacy Enterprises Ltd | Pharmacy | 408 Sunday Lake St, Wakefield, MI 49968-1338 | 2006-07-30 |
| Find all providers in zip 49968 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083220347 | Sivarin Nelson | Counselor | 98 Cedar St Apt 17, Wakefield, MA 01880-2757 | 2020-09-21 |
| 1124642699 | Alison Laura Lee | Counselor | 37 Water St Ste 1, Wakefield, MA 01880-3044 | 2020-06-01 |
| 1952924813 | Timothy Owens | Counselor | 20 Uncle Sams Ln, Wakefield, RI 02879-2377 | 2020-05-26 |
| 1952758229 | Marjorie Kotzamanis | Counselor | 15 Cedar Ct, Wakefield, MA 01880-2249 | 2016-05-17 |
| 1780838565 | Shelagh M Stone | Counselor | 35 S County Commons Way, Suite D-10, Wakefield, RI 02879-8240 | 2008-11-06 |
| 1194910232 | Barbara Joan Dwyer-heidkamp | Counselor | 338 Main St. Suite 304, Riverside Outpatient Center, Wakefield, MA 01880 | 2007-09-12 |
| 1598957896 | Rachel Cs Busch | Counselor | 24 Salt Pond Rd Ste B4, Wakefield, RI 02879-4320 | 2007-08-10 |
| 1770773699 | James William Mcdonald | Counselor | 1077 Main St, Apt 205, Wakefield, MA 01880-4113 | 2007-07-26 |
| 1013058320 | Susan Charlotte Jacobsen | Counselor | 64 Indian Run Trl, Wakefield, RI 02879-1908 | 2007-02-09 |
| 1093862427 | Michelle Oneill | Counselor | 338 Main St Ste 203, Wakefield, MA 01880-5013 | 2007-01-05 |
| Find all providers in WAKEFIELD | ||||
Please comment or provide details below to improve the information on GOGEBIC COUNTY COMMUNITY MENTAL HEALTH AUTHORITY.
| 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.