| Development Centers, Inc. | |
|
24424 W Mcnichols Rd Detroit MI 48219 | |
| (313) 531-2500 | |
| (313) 255-3465 |
| Full Name | Development Centers, Inc. |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 24424 W Mcnichols Rd, Detroit, Michigan |
| Authorized Official Name and Position | Catherine L Liesman (CHIEF EXECUTIVE OFFICE) |
| Authorized Official Contact | 3135312500 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Development Centers, Inc. 17421 Telegraph Rd Detroit MI 48219-3165 Ph: (313) 531-2500 | Development Centers, Inc. 24424 W Mcnichols Rd Detroit MI 48219 Ph: (313) 531-2500 |
| NPI Number | 1326135047 |
|---|---|
| Provider Enumeration Date | 10/06/2006 |
| Last Update Date | 07/24/2018 |
| Medicare PECOS PAC ID | 0547254443 |
|---|---|
| Medicare Enrollment ID | O20040413001246 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326135047 | NPI | - | NPPES |
| 750910618 | Other | MI | BCBSM STATE EMPL ADULT |
| 750910508 | Other | MI | BCBSM STATE EMPL CHILD |
| 800H217310 | Other | MI | BCBS - CSW GROUP |
| 024951 | Other | MI | MIDWEST HEALTH PLAN |
| 260Q276040 | Other | MI | BCBS - DOCTOR GROUP |
| P94406 | Other | MI | BLUE CARE NETWORK |
| Provider Name | Panthia V Thompson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1801224118 PECOS PAC ID: 9931099348 Enrollment ID: I20040318001153 |
| Provider Name | Kehinde A Ayeni |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1366520470 PECOS PAC ID: 8729073580 Enrollment ID: I20040420000261 |
| Provider Name | Janet Lynn Harden |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1902904048 PECOS PAC ID: 8921059320 Enrollment ID: I20050202000954 |
| Provider Name | Stephanie D Stevenson |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1659456184 PECOS PAC ID: 7416993407 Enrollment ID: I20050629001102 |
| Provider Name | Santosh K Rastogi |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1043327117 PECOS PAC ID: 2860570165 Enrollment ID: I20080428000484 |
| Provider Name | Theadia Larue Carey |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1699897728 PECOS PAC ID: 7719055987 Enrollment ID: I20081001000763 |
| Provider Name | Nitin M Rajhans |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1316154156 PECOS PAC ID: 0244384741 Enrollment ID: I20090818000741 |
| Provider Name | Tracie D Cozart-bosely |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1164544763 PECOS PAC ID: 0749325066 Enrollment ID: I20100310000939 |
| Provider Name | Faline C Fisher |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1346376761 PECOS PAC ID: 1850552324 Enrollment ID: I20120410000080 |
| Provider Name | Ramona A Williams |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1093137630 PECOS PAC ID: 9234361965 Enrollment ID: I20140411001528 |
| Provider Name | Alicia Sharp |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1528475902 PECOS PAC ID: 1153610332 Enrollment ID: I20160511000339 |
| Provider Name | Henry C Millbourne |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1902214430 PECOS PAC ID: 4880974757 Enrollment ID: I20161212000517 |
| Provider Name | Anthonia Umelogu |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518485911 PECOS PAC ID: 1759644933 Enrollment ID: I20180423000990 |
| Provider Name | Karen L Douglas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295988533 PECOS PAC ID: 9335576768 Enrollment ID: I20200225001865 |
| Provider Name | Ryan Sexton |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1669676128 PECOS PAC ID: 6204263270 Enrollment ID: I20200304000764 |
| Provider Name | Cory J Vedin |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1952410847 PECOS PAC ID: 1153751532 Enrollment ID: I20200427001585 |
| Provider Name | Roderick L Mills |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1225431109 PECOS PAC ID: 8325453129 Enrollment ID: I20210208002414 |
| Provider Name | Jill A Mccormack |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1730483850 PECOS PAC ID: 4183026503 Enrollment ID: I20210708000177 |
| Provider Name | Destini Haggen |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1841605607 PECOS PAC ID: 9638549512 Enrollment ID: I20230111000315 |
| Provider Name | Ellen Koeppel |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1710442546 PECOS PAC ID: 6406248491 Enrollment ID: I20230203000695 |
| Provider Name | Marcie Beroske |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538500574 PECOS PAC ID: 0244474187 Enrollment ID: I20230427000861 |
| Provider Name | Darla Miles |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457729402 PECOS PAC ID: 0446560429 Enrollment ID: I20230522000422 |
| Provider Name | Thomas Edward Haefner |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1104913177 PECOS PAC ID: 0749626851 Enrollment ID: I20240312001700 |
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