BURDETTE AND DOSS PSYCHOLOGICAL SERVICES LC (NPI# 1073647731) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073647731 |
| Entity Type | Organization |
| Organization Name | BURDETTE AND DOSS PSYCHOLOGICAL SERVICES LC |
| Practice Address |
17352 W 12 Mile Rd Suite 100 Southfield MI 48076-2119 |
| Practice Telephone | 2485590730 |
| Practice Fax Number | 2485697626 |
| Mailing Telephone | 2485590730 |
| Mailing Fax Number | 2485697626 |
| Enumeration Date | 2007-03-15 |
| Last Update Date | 2008-10-28 |
| Authorized Official Name | MS. BARBARA ANN ELISABETH TYSELL (ADMINISTRATIVE DIRECTOR) |
| Authorized Official Telephone | 2485590730 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101Y00000X | Counselor | Behavioral Health & Social Service Providers | ||
| N | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
Behavioral Health & Social Service Providers | ||
| N | 101YM0800X |
Counselor Specialization: Mental Health |
Behavioral Health & Social Service Providers | ||
| N | 103T00000X | Psychologist | Behavioral Health & Social Service Providers | ||
| N | 103TC0700X |
Psychologist Specialization: Clinical |
Behavioral Health & Social Service Providers | ||
| N | 103TC2200X |
Psychologist Specialization: Clinical Child & Adolescent |
Behavioral Health & Social Service Providers | ||
| N | 1041C0700X |
Social Worker Specialization: Clinical |
Behavioral Health & Social Service Providers | ||
| N | 106H00000X | Marriage & Family Therapist | Behavioral Health & Social Service Providers | ||
| N | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
Allopathic & Osteopathic Physicians | ||
| N | 261QR0405X |
Clinic/Center Specialization: Rehabilitation, Substance Use Disorder |
630534 | MI | Ambulatory Health Care Facilities |
| N | 103TP0814X |
Psychologist Specialization: Psychoanalysis |
Behavioral Health & Social Service Providers | ||
| N | 101YP2500X |
Counselor Specialization: Professional |
Behavioral Health & Social Service Providers | ||
| Y | 261QM0801X |
Clinic/Center Specialization: Mental Health (Including Community Mental Health Center) |
630534 | MI | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | MAGELLAN IDENTIFIER | 187925000 | 01 |
| MI | STATE SUBSTANCE ABUSE LIC | 630534 | 01 |
| MI | BCBS PROVIDER ID PHDS | 0912921 | 01 |
| MI | BCBS MANAGED CARE CODE | 10921 | 01 |
| MI | BCBS SUB AB AND MGD CARE | 20700 | 01 |
| MI | WEB DENIS IDENTIFIER | F037350 | 01 |
| MI | BLUE CARE NETWORK PIN | P69427 | 01 |
| MI | NPPESJAMES A. COWLEY NPI | 1316097488 | 01 |
| MI | VALUEOPTIONS | 7509109210 | 01 |
| MI | BCBS OF MICHIGAN | 0910921 | 01 |
| MI | BCBS TRADITIONAL CODE | 750910921 | 01 |
| MI | BCBS NASCO IDENTIFIER | 7509109210 | 01 |
| MI | BCBS PROVIDER ID MDS | 0911921 | 01 |
| MI | BCBS PROVIDER ID MASTERS | 0913921 | 01 |
| MI | VALUE OPTIONS PROVIDER ID | 125750 | 01 |
| MI | NASCO GROUP TRACKING ID | 26 0 F3 2684 0 | 01 |
| MI | HAP PROVIDER ID | 38314498 | 01 |
| Street Address |
17352 W 12 MILE RD SUITE 100 |
| City | SOUTHFIELD |
| State | MI |
| Zip Code | 48076-2119 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861437584 | Zen L.l.c | Home Health | 17352 W 12 Mile Rd, Suite #205, Southfield, MI 48076-2119 | 2006-06-17 |
| 1083951180 | Orchard Adult Day Care, LLC | Clinic/Center | 17352 W 12 Mile Rd, Suite 210, Southfield, MI 48076-2119 | 2013-01-09 |
| 1336439124 | Terry Bethel Troup | Counselor | 17352 W 12 Mile Rd, Suite 100, Southfield, MI 48076-2119 | 2011-04-13 |
| 1427280361 | Julie Ann Woodworth | Marriage & Family Therapist | 17352 W 12 Mile Rd, Suite 100, Southfield, MI 48076-2119 | 2009-08-11 |
| 1548412810 | Specialty Home Health Services, LLC | Home Health | 17352 W 12 Mile Rd, Suite 200, Southfield, MI 48076-2119 | 2008-10-17 |
| 1548428014 | Linda Riley Hathorne | Counselor | 17352 W 12 Mile Rd, Suite 100, Southfield, MI 48076-2119 | 2008-05-30 |
| 1013175587 | Allen Russell Adams | Social Worker | 17352 W 12 Mile Rd, Suite 100, Southfield, MI 48076-2119 | 2008-05-30 |
| 1922125590 | Cheryl Leigh Somers | Psychologist | 17352 W 12 Mile Rd, Suite 100, Southfield, MI 48076-2119 | 2007-03-26 |
| 1649321167 | Mary Katherine Tullio | Social Worker | 17352 W 12 Mile Rd, Suite 100, Southfield, MI 48076-2119 | 2007-01-12 |
| 1316097488 | James Arthur Cowley Sr. | Social Worker | 17352 W 12 Mile Rd, Burdette & Doss Clinic, Southfield, MI 48076 | 2007-01-11 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942813753 | Elaine Sarah Kahn | Social Worker | 15999 West Twelve Mile Rd, Southfield, MI 48076 | 2020-08-31 |
| 1295353829 | Marian Hannah Ibrahim | Dentist | 19189 W 12 Mile Rd, Lathrup Village, MI 48076 | 2020-07-09 |
| 1699317669 | Meadow Lane Rehabilitative Therapies LLC | Social Worker | 29895 Greenfield Rd., Suite 104b, Southfield, MI 48076 | 2019-10-11 |
| 1760035752 | Taliah Laneice Williams-hunter | Counselor | 30119 Sparkleberry Dr., Southfield, MI 48076 | 2019-07-19 |
| 1386114742 | Mavis Gail Pookrum | Technician | 21732 Colony Park Circle #105, Southfield, MI 48076 | 2018-11-28 |
| 1861962417 | Millennial Infusion Centers Inc | Clinic/Center | 26250 Northwestern Hwy Ste 201, Southfield, MI 48076 | 2018-11-27 |
| 1215429212 | Debra Deanes | Counselor | 30233 Southfiels Rd, 203, Southfield, MI 48076 | 2018-06-05 |
| 1437675758 | Kenneth Gerard Giles | Counselor | 29532 Southfield Rd. Suite 208, Southfield, MI 48076 | 2017-08-17 |
| 1902346836 | Linsk Psychiatry Services P C | Clinic/Center | 21751 W 12 Mile Rd, Suite 205, Southfield, MI 48076 | 2017-02-25 |
| 1023552361 | Massage Serenity | Community/Behavioral Health | 20245 W. 12 Mile Rd, Suite 113, Southfield, MI 48076 | 2016-12-06 |
| Find all providers in zip 48076 | ||||
| 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 |
|---|---|---|---|---|
| 1710505987 | S Plus S Enterprises LLC | Clinic/Center | 21650 W 11 Mile Rd Ste 108, Southfield, MI 48076-3715 | 2020-07-13 |
| 1811452758 | Emerge Counseling Services, LLC | Clinic/Center | 30119 Sparkleberry Dr, Southfield, MI 48076-2076 | 2019-02-05 |
| 1902346836 | Linsk Psychiatry Services P C | Clinic/Center | 21751 W 12 Mile Rd, Suite 205, Southfield, MI 48076 | 2017-02-25 |
| 1871531400 | Clark&associates Psychological Services, P.C. | Clinic/Center | 16250 Northland Dr, Suite 245, 16250 Northland Drive, Suite 245, Southfield, MI 48075-5227 | 2006-06-04 |
| 1598746489 | Central Therapeutic Services Inc | Clinic/Center | 17600 W 8 Mile Rd, Suite #7, Southfield, MI 48075-4305 | 2005-11-08 |
| 1992262505 | Stellar Pointe Counseling & Psychological Services LLC | Clinic/Center | 21650 W 11 Mile Rd Ste 107, Southfield, MI 48076-3715 | 2019-03-01 |
| 1730682253 | Envision Wellness LLC | Clinic/Center | 26677 W 12 Mile Rd Ste 136, Southfield, MI 48034-1514 | 2018-03-11 |
| 1336655182 | Transformative Mind Counseling LLC | Clinic/Center | 17368 W 12 Mile Rd Ste 201, Southfield, MI 48076 | 2017-12-15 |
| 1205223419 | Appleseed Professional Development LLC | Clinic/Center | 2000 Town Ctr, Suite1900, Southfield, MI 48075-1135 | 2015-04-26 |
| 1114317476 | Adams Behavioral & Psychological Services PC | Clinic/Center | 17340 W 12 Mile Rd Ste 205, Southfield, MI 48076-6322 | 2015-01-26 |
| Find all providers in SOUTHFIELD | ||||
| City | SOUTHFIELD |
| Zip Code | 48076 |
Please comment or provide details below to improve the information on BURDETTE AND DOSS PSYCHOLOGICAL SERVICES LC.
| 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.