THE BEHAVIORAL CHANGE CLINIC PLLC (NPI# 1073154407) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073154407 |
| Entity Type | Organization |
| Organization Name | THE BEHAVIORAL CHANGE CLINIC PLLC |
| Practice Address |
200 E Big Beaver Rd Troy MI 48083-1208 |
| Practice Telephone | 2485641183 |
| Practice Fax Number | 2484584578 |
| Mailing Telephone | 2485641183 |
| Mailing Fax Number | 2484584578 |
| Enumeration Date | 2019-10-07 |
| Last Update Date | 2020-07-20 |
| Authorized Official Name | DR. DOMINIC CHRISTOPHER MOCERI (PRESIDENT, CLINICAL PSYCHOLOGIST) |
| Authorized Official Telephone | 2485641183 |
| Authorized Official Credential | PHD |
| 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) |
Ambulatory Health Care Facilities |
| Street Address |
200 E BIG BEAVER RD |
| City | TROY |
| State | MI |
| Zip Code | 48083-1208 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437321916 | Ljubisa Tasich | Hearing Instrument Specialist | 200 E Big Beaver Rd, Troy, MI 48083-1208 | 2008-03-25 |
| 1871125658 | Always Best Care Senior Services of Troy, LLC | In Home Supportive Care | 200 E Big Beaver Rd, Troy, MI 48083-1208 | 2020-02-10 |
| 1598324360 | Nita Bhatnagar | In Home Supportive Care | 200 E Big Beaver Rd, Troy, MI 48083-1208 | 2019-06-06 |
| 1558886465 | Upper Hands Home Care | Nursing Care | 200 E Big Beaver Rd, Troy, MI 48083-1208 | 2017-08-11 |
| 1346790888 | Latrina Harris | Licensed Practical Nurse | 200 E Big Beaver Rd, Troy, MI 48083-1208 | 2016-10-07 |
| 1346625225 | Dominic Christopher Moceri | Psychologist | 200 E Big Beaver Rd, Troy, MI 48083-1208 | 2015-07-21 |
| 1205270212 | Booth Counseling Services, P.C. | Social Worker | 200 E Big Beaver Rd, Suite 113, Troy, MI 48083-1208 | 2013-04-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417420449 | Thapasvi Muttirevula | Physical Therapist | 2422 Cedar Knoll Dr, Troy, MI 48083 | 2019-01-02 |
| 1114418290 | Ann Katchke | Physical Therapist | 3179 Livernois Rd, Troy, MI 48083 | 2018-05-23 |
| 1518485945 | Risa Rae Mendelson | Counselor | 1059 Owendale Street, Troy, MI 48083 | 2017-09-06 |
| 1497277115 | Gassan Asadi | Pharmacist | 215 E Big Beaver Rd Ste 500, Troy, MI 48083 | 2017-07-14 |
| 1528510328 | Dylan Skye Polasko | Behavioral Analyst | 2221 E 4th St, #101, Troy, MI 48083 | 2016-10-27 |
| 1235683061 | Sadia Ghazi | Technician, Other | 3178 Daley Dr., Troy, MI 48083 | 2016-08-10 |
| 1548664345 | Amber Leigh Ernst | Social Worker | 1225 E. Big Beaver Road, Troy, MI 48083 | 2014-10-22 |
| 1356782411 | Michelle Louise Knoblock | Nurse Anesthetist, Certified Registered | 1560 E Maple Rd Ste 100, Troy, MI 48083 | 2013-07-17 |
| 1437400728 | Oakland Physicians Surgery Center | Clinic/Center | 1560 E. Maple Road, Suite 100, Troy, MI 48083 | 2012-09-26 |
| 1861748238 | Pro Med Substance Abuse Program LLC | Psychologist | 2891 E. Maple Rd. Suite 200, Troy, MI 48083 | 2012-08-03 |
| Find all providers in zip 48083 | ||||
| Taxonomy Code | 261QM0801X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Mental Health (Including Community Mental Health Center) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952871907 | Radiate Counseling, Pllc | Clinic/Center | 3190 Rochester Rd Ste 106, Troy, MI 48083-5464 | 2018-12-03 |
| 1104331289 | Choices Counseling, Inc. | Clinic/Center | 197b E Us Highway 40, Troy, IL 62294-2262 | 2017-12-11 |
| 1558883652 | Desjardins Therapeutic Services LLC | Clinic/Center | 3190 Rochester Rd Ste 102, Troy, MI 48083-5464 | 2017-07-10 |
| 1285181628 | Pathways Counseling and Wellness Services, LLC | Clinic/Center | 115 Kenyon Dr, Troy, MI 48083-1047 | 2016-09-01 |
| 1508171455 | Illuminations Christian Counseling, Pllc | Clinic/Center | 1157 Shadow Dr, Troy, MI 48085-1779 | 2010-08-16 |
| 1285717413 | East Central Mental Health Mental Retardation, Inc. | Clinic/Center | 200 Cherry St, Troy, AL 36081-2044 | 2006-10-23 |
| 1255943031 | Path To Peace Therapeutic Counseling Center | Clinic/Center | 888 W Big Beaver Rd Ste 780, Troy, MI 48084-4745 | 2020-08-21 |
| 1205476397 | Your Best Self Counseling | Clinic/Center | 2820 W Maple Rd Ste 123, Troy, MI 48084-7047 | 2020-01-07 |
| 1518529049 | Courtney J. Boyd, Phd | Clinic/Center | 200 East Big Beaver Road, Troy, MI 48083 | 2019-07-04 |
| 1861950933 | Compassionate Christ Centered Counseling, LLC | Clinic/Center | 2888 E Long Lake Rd Ste 170, Troy, MI 48085-7011 | 2019-03-07 |
| Find all providers in TROY | ||||
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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.