AMY PARK-GOEDDEKE,LMSW, L.L.C (NPI# 1124681341) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124681341 |
| Entity Type | Organization |
| Organization Name | AMY PARK-GOEDDEKE,LMSW, L.L.C |
| Practice Address |
12151 15 Mile Rd Sterling Heights MI 48312-5120 |
| Mailing Address |
13335 15 Mile Rd # 258 Sterling Heights MI 48312-4271 |
| Practice Telephone | 2489217649 |
| Mailing Telephone | 2489217649 |
| Enumeration Date | 2019-04-15 |
| Last Update Date | 2019-04-15 |
| Authorized Official Name | AMY PARK-GOEDDEKE (DIRECTOR) |
| Authorized Official Telephone | 2489217649 |
| Authorized Official Credential | LMSW |
| 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 |
12151 15 MILE RD |
| City | STERLING HEIGHTS |
| State | MI |
| Zip Code | 48312-5120 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619067063 | Susan Varady PC | Counselor | 12151 15 Mile Rd, Sterling Heights, MI 48312-5120 | 2006-10-14 |
| 1417097700 | Amy Elizabeth Park-goeddeke | Social Worker | 12151 15 Mile Rd, Sterling Heights, MI 48312-5120 | 2007-02-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043701287 | Erin Krugel | Physical Therapist | 33464 Schoenherr Rd Ste 100, Sterling Heights, MI 48312 | 2018-05-23 |
| 1124556691 | Roman Novatchinski | Licensed Practical Nurse | 13654 Brougham, Sterling Heights, MI 48312 | 2017-05-30 |
| 1679010763 | Lake City Pharmacy, LLC | Durable Medical Equipment & Medical Supplies | 33389 Van Dyke Ave, Sterling Heights, MI 48312 | 2017-01-26 |
| 1598113912 | Joseph Donald Evens | Occupational Therapist | 11635 Filer Drive, Sterling Heights, MI 48312 | 2016-05-26 |
| 1942656855 | Damini Desai | Technician, Other | 38157 Corbett Dr, Sterling Heights, MI 48312 | 2016-05-10 |
| 1891151593 | Your Healing Hands Massage Therapy, LLC | Massage Therapist | 6029 E 14 Mile Rd Ste 200, Sterling Heights, MI 48312 | 2016-01-11 |
| 1033539069 | Macomb County Community Mental Health | Community/Behavioral Health | 6555 15 Mile Road, Sterling Heights, MI 48312 | 2014-04-17 |
| 1467705871 | Julie Anne Hepke | Social Worker | 13213 E. 14 Mile Road, Sterling Heights, MI 48312 | 2012-10-23 |
| 1619226354 | Kimberly Marie Dorband | Physical Therapy Assistant | 6041 15 Mile Road, Sterling Heights, MI 48312 | 2012-09-07 |
| 1477810026 | Frances Sherryl Salvadora Ramos | Physical Therapist | 8170 Crestview Dr Apt 6, Sterling Heights, MI 48312 | 2012-04-20 |
| Find all providers in zip 48312 | ||||
| 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 |
|---|---|---|---|---|
| 1700492154 | Bound Together Counseling, Pllc | Clinic/Center | 3020 Franklin Park Dr, Sterling Heights, MI 48310-2477 | 2020-09-21 |
| 1801441241 | Well Tree Therapy Associates, PC | Clinic/Center | 13425 19 Mile Rd Ste 200, Sterling Heights, MI 48313-1991 | 2019-08-02 |
| 1457479917 | North Point-pioneer, Inc | Clinic/Center | 36250 Dequindre Rd, Suite 310, Sterling Heights, MI 48310-7143 | 2007-03-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225637267 | Thompson Counseling & Consulting LLC | Clinic/Center | 36500 Ford Rd Ste 329, Westland, MI 48185-3769 | 2020-10-21 |
| 1720685464 | Thiera Danyal Therapy and Wellness LLC | Clinic/Center | 10216 Beaconsfield St, Detroit, MI 48224-2573 | 2020-10-06 |
| 1871100602 | Sbh Ventures LLC | Clinic/Center | 700 Golfcrest Dr, Dearborn, MI 48124-1121 | 2020-09-25 |
| 1558978593 | Katie M Wyss Lmsw, LLC | Clinic/Center | 218 N 4th Ave Ste 207, Ann Arbor, MI 48104-1472 | 2020-09-24 |
| 1982219556 | Best Life Counseling Services, LLC | Clinic/Center | O-745 Lake Michigan Dr Nw, Grand Rapids, MI 49534-6795 | 2020-09-10 |
| 1780297879 | Grisham Services Inc. | Clinic/Center | 710 Chippewa Sq Ste 206, Marquette, MI 49855-4823 | 2020-08-28 |
| 1518579655 | Self Preservation Through Recovery Independence Transformation Guidanc | Clinic/Center | 21225 Kelly Rd Ste 5, Eastpointe, MI 48021-3100 | 2020-08-19 |
| 1639789688 | Itherapygenx, Pllc | Clinic/Center | 31701 Grandview Ave, Westland, MI 48186-8958 | 2020-08-05 |
| 1619595832 | Peace of Mind, LLC | Clinic/Center | 41750 Foster Dr Unit 204, Novi, MI 48375-1976 | 2020-07-14 |
| 1710505987 | S Plus S Enterprises LLC | Clinic/Center | 21650 W 11 Mile Rd Ste 108, Southfield, MI 48076-3715 | 2020-07-13 |
| Find all providers with the same taxonomy | ||||
| City | STERLING HEIGHTS |
| Zip Code | 48312 |
Please comment or provide details below to improve the information on AMY PARK-GOEDDEKE,LMSW, L.L.C.
| 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.