| Southfield Mental Health Associates Pc | |
|
17320 W 12 Mile Rd Suite 101 Southfield MI 48076-2102 | |
| (248) 557-3606 | |
| (248) 557-4697 |
| Full Name | Southfield Mental Health Associates Pc |
|---|---|
| Speciality | Clinic/Center |
| Location | 17320 W 12 Mile Rd, Southfield, Michigan |
| Authorized Official Name and Position | Lawrence J Gusman (OWNER PRESIDENT) |
| Authorized Official Contact | 2485573606 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Southfield Mental Health Associates Pc 17320 W 12 Mile Rd Suite 101 Southfield MI 48076-2102 Ph: (248) 557-3606 | Southfield Mental Health Associates Pc 17320 W 12 Mile Rd Suite 101 Southfield MI 48076-2102 Ph: (248) 557-3606 |
| NPI Number | 1619015872 |
|---|---|
| Provider Enumeration Date | 02/01/2007 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 9931507514 |
|---|---|
| Medicare Enrollment ID | O20211012002576 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619015872 | NPI | - | NPPES |
| 302643 | Other | MI | VALUE OPTIONS |
| 7509106210 | Other | MI | BLUE CROSS MICHIGAN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Tracy L Niyo |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1518435635 PECOS PAC ID: 9739154410 Enrollment ID: I20040826001063 |
| Provider Name | Theadia Larue Carey |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1699897728 PECOS PAC ID: 7719055987 Enrollment ID: I20081001000763 |
| Provider Name | Alisha K Whitney |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1154724474 PECOS PAC ID: 7416254602 Enrollment ID: I20160404000640 |
| Provider Name | Steven J Ware |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1063877652 PECOS PAC ID: 3678816725 Enrollment ID: I20190514000367 |
| Provider Name | Karen L Douglas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295988533 PECOS PAC ID: 9335576768 Enrollment ID: I20200225001865 |
| Provider Name | Nancy Brennan |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1598155442 PECOS PAC ID: 7416371463 Enrollment ID: I20211012002710 |
| Provider Name | Maureen Mcglinn |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1801342316 PECOS PAC ID: 0143618694 Enrollment ID: I20211102002480 |
| Provider Name | Daicia Price |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1174952675 PECOS PAC ID: 3173990462 Enrollment ID: I20221028001594 |
| Provider Name | Brodie James Lobb |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1174173876 PECOS PAC ID: 1951797372 Enrollment ID: I20221031002320 |
| Provider Name | Gage Paul Gorski |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1568011955 PECOS PAC ID: 5496158651 Enrollment ID: I20240319003060 |
| Provider Name | Karen Bashawaty |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1881739605 PECOS PAC ID: 8426217944 Enrollment ID: I20240801000362 |
| Provider Name | Myranda Jennings |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1104364124 PECOS PAC ID: 3173060274 Enrollment ID: I20240807002371 |
| Provider Name | Catherine Rose Adamowski |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1013631514 PECOS PAC ID: 5991246688 Enrollment ID: I20240921000121 |
| Provider Name | Sarah Redman |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1275202269 PECOS PAC ID: 6800337593 Enrollment ID: I20240921000129 |
| Provider Name | Laura Sacks Kohn |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1326184912 PECOS PAC ID: 5890236582 Enrollment ID: I20240921000170 |
| Provider Name | Danielle Renee Dickens |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1659863579 PECOS PAC ID: 6709327497 Enrollment ID: I20240921000174 |
| Provider Name | Sean Madigan Hoen |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1861122475 PECOS PAC ID: 4880135573 Enrollment ID: I20240921000205 |
| Provider Name | Sierra Kenan Hendrix-williams |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1174115927 PECOS PAC ID: 4486195195 Enrollment ID: I20240923000114 |
| Provider Name | Rebecca Marie Smith |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1417715632 PECOS PAC ID: 9436690732 Enrollment ID: I20240925004212 |
| Provider Name | Sean Mcgraw |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1043637960 PECOS PAC ID: 3870963697 Enrollment ID: I20240930001497 |
| Provider Name | Deirdre Anne King |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1689037350 PECOS PAC ID: 3971036732 Enrollment ID: I20241031002814 |
Whole Body Health And Wellness Center Inc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 17250 W 12 Mile Rd, Southfield, MI 48076 Phone: 248-632-6737 | |
Life Centers, Inc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 16000 W 9 Mile Rd Ste 200, Southfield, MI 48075 Phone: 248-579-2188 Fax: 248-715-5903 | |
Neurobehavioral Services, P.c. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 29260 Franklin Rd, Suite 101, Southfield, MI 48034 Phone: 248-569-8700 Fax: 248-856-9373 | |
Christina L Shoemaker Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 29540 Southfield Rd Ste 101, Southfield, MI 48076 Phone: 248-506-3399 | |
Dahlia Berkovitz Phd Pllc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 29623 Northwestern Hwy Lowr Level, Southfield, MI 48034 Phone: 248-760-8550 | |
I Need A Moment, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 20411 Alhambra St, Southfield, MI 48076 Phone: 248-550-2725 |