ASCENSION EASTWOOD BEHAVIORAL HEALTH (NPI# 1336367804) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336367804 |
| Entity Type | Organization |
| Organization Name | ASCENSION EASTWOOD BEHAVIORAL HEALTH |
| Other Organization Name | EASTWOOD CLINICS |
| Practice Address |
22151 Moross, Pb1 Suite 334 Detroit MI 48236-2114 |
| Mailing Address |
2800 Livernois Rd Ste 500 Troy MI 48083-1219 |
| Practice Telephone | 3133437230 |
| Practice Fax Number | 3133437449 |
| Mailing Telephone | 2486808203 |
| Mailing Fax Number | 2486808203 |
| Enumeration Date | 2007-04-23 |
| Last Update Date | 2019-09-16 |
| Authorized Official Name | STEVEN CANDELA (DIRECTOR) |
| Authorized Official Telephone | 5867530400 |
| Authorized Official Credential | LMSW |
| Is Organization Subpart | Y |
| Parent Organization Name | EASTWOOD COMMUNITY CLINICS |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101Y00000X | Counselor | Behavioral Health & Social Service Providers | ||
| N | 104100000X | Social Worker | Behavioral Health & Social Service Providers | ||
| N | 106H00000X | Marriage & Family Therapist | Behavioral Health & Social Service Providers | ||
| N | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
Allopathic & Osteopathic Physicians | ||
| Y | 103T00000X | Psychologist | Behavioral Health & Social Service Providers |
| Other Name | Type Code |
|---|---|
| Eastwood Clinics | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992168983 | Ascension Eastwood Behavioral Health | Psychologist | 11270 E 13 Mile Rd Ste 2, Warren, MI 48093-2599 | 2016-03-29 |
| 1568768711 | Ascension Eastwood Behavioral Health | Psychiatry & Neurology | 2800 Livernois Rd Ste 500, Troy, MI 48083-1219 | 2011-02-07 |
| 1144422494 | Ascension Eastwood Behavioral Health | Psychiatry & Neurology | 44000 W 12 Mile Rd Ste 101, Novi, MI 48377 | 2007-05-31 |
| 1932329166 | Ascension Eastwood Behavioral Health | Counselor | 22151 Morros, Pb1, Suite 334, Detroit, MI 48236-2114 | 2007-04-30 |
| 1023238250 | Ascension Eastwood Behavioral Health | Psychologist | 22255 Greenfield Road, Suite 300, Southfield, MI 48075-3700 | 2007-04-30 |
| 1851519359 | Ascension Eastwood Behavioral Health | Counselor | 110 W. South Blvd, Suite 200, Rochester Hills, MI 48307-5150 | 2007-04-23 |
| 1104044676 | Ascension Eastwood Behavioral Health | Counselor | 22708 Harper Avenue, St. Clair Shores, MI 48315-6033 | 2007-04-23 |
| 1740408244 | Ascension Eastwood Behavioral Health | Counselor | 30701 Woodward Avenue, Suite 200, Royal Oak, MI 48073-0987 | 2007-04-23 |
| 1922116938 | Ascension Eastwood Behavioral Health | Substance Abuse Rehabilitation Facility | 1515 N Stephenson Hwy, Royal Oak, MI 48067-1526 | 2006-08-29 |
| 1396787701 | Ascension Eastwood Behavioral Health | Counselor | 35455 Garfield Rd, Clinton Township, MI 48035-2236 | 2006-06-11 |
| Street Address |
22151 MOROSS, PB1 SUITE 334 |
| City | DETROIT |
| State | MI |
| Zip Code | 48236-2114 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093323966 | Khairya Fatouh | Pathology | 22101 Morros Road, Pathology Department, Detroit, Detroit, MI 48236 | 2020-07-16 |
| 1134744998 | Harish Harry Gidda | Internal Medicine | 22201 Moross Rd, Suite 50, Detroit, MI 48236 | 2020-06-08 |
| 1770107443 | Arshan Ali Khan | Internal Medicine | 22101 Moross Rd, Suite 50, Detroit, MI 48236 | 2020-05-29 |
| 1750901658 | Annika Van Wieren | Emergency Medicine | 22101 Moross Road, Emergency Department, Detroit, MI 48236 | 2020-04-21 |
| 1801449483 | Ishaq Azeem Asghar | Student in an Organized Health Care Education/Training Program | 22101 Moross Road, Pathology Department, Detroit, MI 48236 | 2019-07-22 |
| 1295290443 | Ascension St. John Hospital | Dietitian, Registered | 22201 Moross, Ste. 270, Detriot, MI 48236 | 2019-02-01 |
| 1548747413 | Abiodun Adenuga Adefarasin | Pharmacist | 20746 Mack Avenue, Gross Pointe Woods, MI 48236 | 2018-07-24 |
| 1629564042 | Hamza H Khan | Student in an Organized Health Care Education/Training Program | 22201 Moross, Professional Building 2, Suite 70, Detroit, MI 48236 | 2018-07-09 |
| 1235631664 | David Lee Williams | Physical Therapist | 159 Kercheval Avenue, Grosse Pointe Farms, MI 48236 | 2018-03-01 |
| 1164979720 | Memphie Morgan | Licensed Practical Nurse | 91527 Cheshire St., Grosse Pointe, MI 48236 | 2016-09-01 |
| Find all providers in zip 48236 | ||||
| Taxonomy Code | 103T00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public. |
| Notes: Source: American Psychological Association [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285129221 | Wayne State University | Psychologist | 540 E Canfield St Ste 1241, Detroit, MI 48201 | 2018-06-22 |
| 1508362922 | Claudia Anagurthi | Psychologist | Chm/specilty Center, 3950 Beaubien Ground Fl, Detroit, MI 48201 | 2018-04-04 |
| 1992136295 | Marilyn Franklin | Psychologist | 9000 E Jefferson Ave Apt 28-17, Detroit, MI 48214-2940 | 2013-12-12 |
| 1144669318 | Julia Helene Bellamy | Psychologist | 3901 Chrysler Dr Ste 3b, Detroit, MI 48201-2167 | 2013-06-20 |
| 1255675005 | Nicole Henriksen | Psychologist | 4201 Saint Antoine St Ste 4b, Detroit, MI 48201 | 2012-11-17 |
| 1093061517 | Kinneta Easter Mason | Psychologist | 19738 Fielding St, Detroit, MI 48219 | 2012-08-02 |
| 1376859785 | Eugene Ronald Craig | Psychologist | 300 Riverfront Dr, Suite 16 H, Detroit, MI 48226-4516 | 2010-08-23 |
| 1902126725 | Dana Raquel Lasenby | Psychologist | 3434 Russell St, Suite #307, Detroit, MI 48207-2062 | 2010-06-03 |
| 1699004614 | Monica Anne Moore | Psychologist | 18940 Oak Dr, Detroit, MI 48221-2264 | 2009-12-22 |
| 1750610796 | Sekai Denard Broaden | Psychologist | 14952 Rosemont Ave, Detroit, MI 48223-2364 | 2009-12-22 |
| Find all providers in DETROIT | ||||
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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.