MENTAL HEALTH CLINIC (NPI# 1184822769) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1184822769 |
| Entity Type | Organization |
| Organization Name | MENTAL HEALTH CLINIC |
| Practice Address |
1514 W Milham Ave Portage MI 49024-1296 |
| Practice Telephone | 2693420606 |
| Practice Fax Number | 2693420919 |
| Mailing Telephone | 2693420606 |
| Mailing Fax Number | 2693420919 |
| Enumeration Date | 2007-07-05 |
| Last Update Date | 2008-10-09 |
| Authorized Official Name | DR. RAVINDER P MEDIRATTA (OWNER) |
| Authorized Official Telephone | 2693420606 |
| Authorized Official Credential | M D |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101YM0800X |
Counselor Specialization: Mental Health |
6401009051 | MI | Behavioral Health & Social Service Providers |
| Y | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
RM4301052512 | MI | Allopathic & Osteopathic Physicians |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | MENTAL HEALTH CLINIC | 1921 N Market St, Monticello, IL 61856-8144 |
| System for Award Management (SAM) Entities | MENTAL HEALTH CLINIC OF PASSAIC | 1451 Van Houten, Clifton, NJ 07013-2432 |
| Street Address |
1514 W MILHAM AVE |
| City | PORTAGE |
| State | MI |
| Zip Code | 49024-1296 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003991191 | Ravinder Mediratta | Psychiatry & Neurology | 1514 W Milham Ave, Portage, MI 49024-1296 | 2006-10-26 |
| 1124302393 | Kristin Rae Gillen | Psychologist | 1514 W Milham Ave, Portage, MI 49024-1296 | 2011-10-05 |
| 1306092788 | Carrie Jane Mckean | Counselor | 1514 W Milham Ave, Portage, MI 49024-1296 | 2008-08-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134774524 | Antonio Richard Barron | Physician Assistant | 5717 Oakland Dr Ste A, Portage, MI 49024 | 2019-08-03 |
| 1699279240 | Julie Lynn Griffin | Specialist/Technologist | Portage Northern High School, 1000 Idaho Ave, Portage, MI 49024 | 2018-03-20 |
| 1194255711 | Brittany Lynn Finkler | Audiologist | 576 Romence Rd Ste 121, Portage, MI 49024 | 2017-06-15 |
| 1164881207 | Family & Children Services, Inc. | Clinic/Center | 1302 W Milham Ave, Portage, MI 49024 | 2016-02-17 |
| 1497127716 | Huber Counseling, LLC | Counselor | 1591 West Centre Ave, Suite 102, Portage, MI 49024 | 2015-10-26 |
| 1659757466 | Marie Porter | Rehabilitation Practitioner | 5724 Alten St, Portage, MI 49024 | 2015-08-04 |
| 1063824860 | George Hughes | General Practice | 6630 Sunburst Dr, Portage, MI 49024 | 2014-05-28 |
| 1922358407 | Kimberly Lynn Ellrich | Speech-Language Pathologist | Storypoint, 3951 W Milham Ave, Portage, MI 49024 | 2012-09-12 |
| 1942593744 | Shamika Hall, Ph.d. & Associates, Pllc | Community/Behavioral Health | 7901 S. 12th St., Suite 201, Portage, MI 49024 | 2011-05-26 |
| 1306142815 | Jody Lynn Wrathall | Dentist | 3020 Old Centre Rd, Portage, MI 49024 | 2011-01-31 |
| Find all providers in zip 49024 | ||||
| Taxonomy Code | 2084P0800X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Psychiatry |
| A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518585462 | Tracy Lynn Genovese | Psychiatry & Neurology | 2718 Laguardia St, Portage, IN 46368-3139 | 2020-07-08 |
| 1114219227 | South Michigan Psychiatric Services LLC | Psychiatry & Neurology | 5390 Lovers Ln, Third Floor, Portage, MI 49002 | 2011-05-07 |
| 1174836316 | Premier Neuropsychiatry Plc | Psychiatry & Neurology | 5930 Lovers Lane, Portage, MI 49002 | 2010-07-16 |
| 1639330624 | Kevin Anthony Kunzer | Psychiatry & Neurology | 1350 W Centre Ave Ste 110, Portage, MI 49024-5361 | 2008-06-23 |
| 1205103793 | Belal Hegazy | Psychiatry & Neurology | 6050 Sterling Creek Rd, Portage, IN 46368-7752 | 2011-11-28 |
| 1437352689 | Niaz Mohammad | Psychiatry & Neurology | 7895 Currier Dr, Portage, MI 49002-4314 | 2007-06-06 |
| 1255436705 | Mario Rl Valenzuela | Psychiatry & Neurology | 2901 Hunters Trl, Portage, WI 53901-3403 | 2006-09-13 |
| 1063526580 | Tammy Ann Pierner | Psychiatry & Neurology | 2901 Hunters Trl, Portage, WI 53901-3403 | 2006-08-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720686165 | Centia Health LLC | Psychiatry & Neurology | 23802 Wintergreen Cir, Novi, MI 48374-3681 | 2020-10-16 |
| 1114524428 | Clarity Behavioral Health Pllc | Psychiatry & Neurology | 7154 Merrybrook, West Bloomfield, MI 48322-4066 | 2020-10-08 |
| 1790395978 | Amiri Psychiatric Services Pllc | Psychiatry & Neurology | 1695 W Saratoga St, Ferndale, MI 48220-3153 | 2020-08-03 |
| 1881211191 | Infinite Wellness Healthcare, Pllc | Psychiatry & Neurology | 19855 Outer Dr Ste 504e, Dearborn, MI 48124-2040 | 2020-07-02 |
| 1528680303 | Emilia Elizabeth Mattioli | Psychiatry & Neurology | 965 Fee Road Room A223, East Lansing, MI 48824 | 2020-05-14 |
| 1447871983 | James O'brien | Psychiatry & Neurology | Msu Psychiatry Residency Program, 965 Fee Road, Room A233, East Lansing, MI 48824 | 2020-05-06 |
| 1083247134 | Actify Neurotherapies, Pllc | Psychiatry & Neurology | 28475 Greenfield Rd Ste 113, Southfield, MI 48076-3034 | 2020-02-18 |
| 1720611734 | Brightside Medical of Michigan, P.C. | Psychiatry & Neurology | Telemedicine Services Only / No Physical Office, Telemedicine Services Only / No Physical, MI 48170 | 2020-02-18 |
| 1922646538 | Sylvia Hanson Md Pllc | Psychiatry & Neurology | 6461 Golden Ln, West Bloomfield, MI 48322-3096 | 2019-12-13 |
| 1740823129 | Tms Wellness Clinic of Michigan Pllc | Psychiatry & Neurology | 5757 W Maple Rd Ste 800-b, West Bloomfield, MI 48322-2277 | 2019-10-18 |
| Find all providers with the same taxonomy | ||||
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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.