AUSABLE VALLEY COMMUNITY MENTAL HEALTH SERVICES BOARD (NPI# 1417011701) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417011701 |
| Entity Type | Organization |
| Organization Name | AUSABLE VALLEY COMMUNITY MENTAL HEALTH SERVICES BOARD |
| Practice Address |
1199 W Harris Ave Tawas City MI 48764-9310 |
| Mailing Address |
1199 W Harris Ave Po Box 310 Tawas City MI 48764-9310 |
| Practice Telephone | 9893628636 |
| Mailing Telephone | 9893628636 |
| Enumeration Date | 2006-12-20 |
| Last Update Date | 2010-06-08 |
| Authorized Official Name | DR. FLOYD SMITH (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 9893628636 |
| Authorized Official Credential | PHD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251S00000X | Community/Behavioral Health | Agencies |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | 1706830 | 05 | |
| MI | 4456570 | 05 | |
| MI | 4811060 | 05 |
| Street Address |
1199 W HARRIS AVE |
| City | TAWAS CITY |
| State | MI |
| Zip Code | 48764-9310 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013540665 | Jamily Axline | Social Worker | 119 Harris Ave, Tawas City, MI 48764 | 2020-02-21 |
| 1760036222 | Karen Heier | Community Health Worker | 1199 W Harris St, Tawas City, MI 48764 | 2019-08-01 |
| 1922211325 | Ricardo Melegrito Velasco | Physical Therapist | 110 Beech Street, Tawas City, MI 48764 | 2007-05-08 |
| 1609803659 | Jon M Kaliszewski Md PC | Anesthesiology | 200 Hemlock M-55, Tawas, MI 48764 | 2006-06-26 |
| 1912943036 | Michele M Stockton | Chiropractor | 1113 W Lake St, Tawas City, MI 48764 | 2006-06-20 |
| 1497973762 | Alliance Imaging Inc | Clinic/Center | 200 Hemlock St, Tawas City, MI 48764 | 2007-04-23 |
| 1457389769 | Jon Mark Kaliszewski | Anesthesiology | 200 Hemlock M-55, Tawas, MI 48764 | 2006-06-28 |
| 1609395888 | Mandy Grenier | Counselor | Po Box 310, Tawas City, MI 48764-0310 | 2017-09-19 |
| 1902126667 | Charity C Simpkins | Dietitian, Registered | 200 Hemlock, Tawas City, MI 48764-0659 | 2010-06-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750980314 | Greg Malewska | Nurse Practitioner | 420 W Lake St, Tawas City, MI 48763-8309 | 2020-10-23 |
| 1952913667 | Amber Lyn Hatcher | Occupational Therapist | 2682 Miller Rd, Tawas City, MI 48763-8619 | 2020-08-24 |
| 1932722907 | Nancy Clark | Occupational Therapist | 1147 S Bay Dr, Tawas City, MI 48763-9318 | 2020-05-25 |
| 1013540665 | Jamily Axline | Social Worker | 119 Harris Ave, Tawas City, MI 48764 | 2020-02-21 |
| 1760036222 | Karen Heier | Community Health Worker | 1199 W Harris St, Tawas City, MI 48764 | 2019-08-01 |
| 1285115733 | Rebekah Ann Palmer | Behavior Technician | 300 Margo St, Tawas City, MI 48763-9223 | 2018-08-23 |
| 1770074015 | Thomas Paul Rautenberg | Physical Therapist | 1320 S Rempert Rd, Tawas City, MI 48763-9583 | 2018-05-22 |
| 1609395888 | Mandy Grenier | Counselor | Po Box 310, Tawas City, MI 48764-0310 | 2017-09-19 |
| 1629528724 | Theodore Hoxie | Technician, Other | 560 E M 55, Tawas City, MI 48763-9227 | 2016-10-12 |
| 1003363938 | Tricia Briggs | Technician, Other | 317 8th Ave, Tawas City, MI 48763-9792 | 2016-09-08 |
| Find all providers in TAWAS CITY | ||||
| Taxonomy Code | 251S00000X |
| Grouping | Agencies |
| Classification | Community/Behavioral Health |
| A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, mental retardation, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. |
| Notes: Source: National Medicaid EDI HIPAA NPI Sub Work Group [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477031680 | Lori Enos | Community/Behavioral Health | 1199 Harris Ave, Tawas City, MI 48763 | 2018-07-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295336394 | Kcs Community Services Inc | Community/Behavioral Health | 16577 Muirland St, Detroit, MI 48221-3012 | 2020-11-04 |
| 1407457864 | Initial Steps Behavioral and Learning Services | Community/Behavioral Health | 50203 Paine St, Canton, MI 48188-3332 | 2020-11-03 |
| 1720688617 | Mjw Counseling Services | Community/Behavioral Health | 564 Marcia St Sw, Wyoming, MI 49509-4013 | 2020-10-29 |
| 1174122345 | Allison Johnston Lpc | Community/Behavioral Health | 51500 Birch St. Suite C, New Baltimore, MI 48047 | 2020-10-20 |
| 1003414632 | Res-care Premier, Inc. | Community/Behavioral Health | 209 Kings Ln, Battle Creek, MI 49014-7832 | 2020-10-15 |
| 1104423508 | Cherry Street Services Inc | Community/Behavioral Health | 100 Wexford St Se Rm 214, Wyoming, MI 49548-2212 | 2020-10-08 |
| 1447857156 | Lauren Elizabeth Thayer | Community/Behavioral Health | 3257 City View Ct, Hudsonville, MI 49426-9013 | 2020-10-06 |
| 1093312613 | Guarding Therapy & Counseling Services, Pllc | Community/Behavioral Health | 26847 Grand River Ave Ste 24, Redford, MI 48240-1544 | 2020-10-06 |
| 1053928507 | Therapy With Nicole Pllc | Community/Behavioral Health | 4867 E. Beltline Ave. Ne, Building #1 Lower Level, Grand Rapids, MI 49525 | 2020-09-29 |
| 1013524032 | I Need A Moment, LLC | Community/Behavioral Health | 20411 Alhambra St, Southfield, MI 48076-5422 | 2020-09-24 |
| Find all providers with the same taxonomy | ||||
| City | TAWAS CITY |
| Zip Code | 48764 |
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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.