WISE MIND PLLC (NPI# 1982147302) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1982147302 |
| Entity Type | Organization |
| Organization Name | WISE MIND PLLC |
| Practice Address |
905 S Center St Royal Oak MI 48067-3230 |
| Practice Telephone | 5174990991 |
| Mailing Telephone | 5174990991 |
| Enumeration Date | 2016-12-02 |
| Last Update Date | 2016-12-02 |
| Authorized Official Name | DR. ANTOINETTE CROCILLA (PSYCHOLOGIST/OWNER) |
| Authorized Official Telephone | 5174990991 |
| Authorized Official Credential | PSYD LP |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM0801X |
Clinic/Center Specialization: Mental Health (Including Community Mental Health Center) |
6301016439 | MI | Ambulatory Health Care Facilities |
| Street Address |
905 S CENTER ST |
| City | ROYAL OAK |
| State | MI |
| Zip Code | 48067-3230 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891907838 | Henry M Traurig | Psychologist | 905 S Center St, Royal Oak, MI 48067-3230 | 2007-05-03 |
| 1265053029 | Henry M Traurig, PC | Psychologist | 905 S Center St, Royal Oak, MI 48067-3230 | 2020-05-04 |
| 1790148815 | Scott Macinnis | Psychologist | 905 S Center St, Royal Oak, MI 48067-3230 | 2016-04-05 |
| 1033595665 | Fairsky Foundation | Psychologist | 905 S Center St, Royal Oak, MI 48067-3230 | 2015-08-05 |
| 1881090587 | Nancy A Sparrow Lmsw LLC | Counselor | 905 S Center St, Royal Oak, MI 48067-3230 | 2014-11-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922609072 | George Edward Khamis | Psychologist | 25600 Woodward Avenue, Suite 215, Royal Oak, MI 48067 | 2020-11-05 |
| 1205443751 | Crossover Health Medical Group | Clinic/Center | 424 E. 4th St, Suite 100, Royal Oak, MI 48067 | 2020-09-29 |
| 1750917811 | Sonia B Shah-gonzalez | Case Management | 830 E Fourth St, #1, Royal Oak, MI 48067 | 2020-03-19 |
| 1568022960 | Woodo Pharmacy LLC | Pharmacy | 909 E 11 Mile Rd, Royal Oak, MI 48067 | 2019-06-18 |
| 1093217564 | Sharon Diane Malinowski | Occupational Therapist | 4949 Coolidge Hwy Section E, Adult Neuro Ot, Royal Oak, MI 48067 | 2018-03-01 |
| 1962916569 | Nuch of Michigan Inc | Clinic/Center | 2140 E 12 Mile Rd, Royal Oak, MI 48067 | 2017-11-20 |
| 1629420179 | Christine Paige | Homeopath | 1112 Catalpa, Royal Oak, MI 48067 | 2016-07-08 |
| 1104277045 | Rppc Labs, LLC | Clinical Medical Laboratory | 26154 Woodward Ave Ste 5, Royal Oak, MI 48067 | 2016-06-22 |
| 1346606423 | Thomas Michalos | Counselor | 402 S. Lafayette, Royal Oak, MI 48067 | 2016-01-05 |
| 1508234212 | Valetta Aldridge | Registered Nurse | 28000 Woodward, Royal Oak, MI 48067 | 2015-09-11 |
| Find all providers in zip 48067 | ||||
| Taxonomy Code | 261QM0801X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Mental Health (Including Community Mental Health Center) |
| Definition to come... |
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|---|---|---|---|---|
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| 1326317462 | Jump Start Consulting, LLC | Clinic/Center | 317 E 11 Mile Rd, Royal Oak, MI 48067-2735 | 2011-12-19 |
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| 1780297879 | Grisham Services Inc. | Clinic/Center | 710 Chippewa Sq Ste 206, Marquette, MI 49855-4823 | 2020-08-28 |
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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.