MOSAIC CENTER FOR INTEGRATIVE THERAPY, LLC (NPI# 1518208008) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1518208008 |
| Entity Type | Organization |
| Organization Name | MOSAIC CENTER FOR INTEGRATIVE THERAPY, LLC |
| Practice Address |
2202 Mitchell Park Dr Suite 2b Petoskey MI 49770-8897 |
| Practice Telephone | 2314871750 |
| Practice Fax Number | 2314871754 |
| Mailing Telephone | 2314871750 |
| Mailing Fax Number | 2314871754 |
| Enumeration Date | 2013-03-07 |
| Last Update Date | 2013-11-01 |
| Authorized Official Name | BRENDA ENNIS (BUSNIESS OWNER / THERAPIST) |
| Authorized Official Telephone | 2314871750 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251S00000X | Community/Behavioral Health | 6801085534 | MI | Agencies |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TYPE I NPI | 1386972446 | 01 |
| Street Address |
2202 MITCHELL PARK DR SUITE 2B |
| City | PETOSKEY |
| State | MI |
| Zip Code | 49770-8897 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740397199 | John Marino Cilluffo | Neurological Surgery | 2202 Mitchell Park Dr, Suite 6, Petoskey, MI 49770-8897 | 2006-08-23 |
| 1063887230 | Psychnorth | Clinic/Center | 2202 Mitchell Park Dr, Ste 5, Petoskey, MI 49770-8897 | 2015-12-14 |
| 1821477845 | The Men's Counseling Center of Northern Michigan, LLC | Community/Behavioral Health | 2202 Mitchell Park Dr, Suite 2b, Petoskey, MI 49770-8897 | 2015-05-22 |
| 1508295908 | Joann Haderer | Nurse Practitioner | 2202 Mitchell Park Dr, Unit 5, Petoskey, MI 49770-8897 | 2013-11-06 |
| 1801195102 | Brian B Lehky Phd PC | Psychologist | 2202 Mitchell Park Dr, Unit 5, Petoskey, MI 49770-8897 | 2011-03-25 |
| 1386972446 | Brenda Marie Ennis | Social Worker | 2202 Mitchell Park Dr, Suite 2b, Petoskey, MI 49770-8897 | 2009-12-01 |
| 1528113826 | Brian B Lehky | Psychologist | 2202 Mitchell Park Dr, Unit 5, Petoskey, MI 49770-8897 | 2007-01-24 |
| 1245303973 | Susan C. Finley | Counselor | 2202 Mitchell Park Dr, Suite 003, Petoskey, MI 49770-8897 | 2006-11-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780231985 | Olivia Michelle Seaman | Pharmacist | 1301 U.S. 31 N. Hwy, Petoskey, MI 49770 | 2019-08-22 |
| 1649733148 | Harbor Hall, Inc. | Clinic/Center | 302 Orchard Ridge Drive, Petoskey, MI 49770 | 2019-04-11 |
| 1053802942 | Devin Hueston | Dentist | 231 State St Ste 3, Petoskey, MI 49770 | 2018-05-25 |
| 1720585037 | Jacob Kenneth Tracy | Counselor | 410 E Lake Street, Suite 100, Petoskey, MI 49770 | 2018-04-12 |
| 1013424191 | Timothy Robert La Gasse | Nurse Practitioner | 401 Connable Ave, Petoskey, MI 49770 | 2018-01-10 |
| 1609303676 | Shauna Sue Stark | Nurse Practitioner | 560 W Mitchell St Ste 505, Petoskey, MI 49770 | 2017-05-22 |
| 1053851519 | Maureen Todd | Counselor | 703 Emmet St, Petoskey, MI 49770 | 2017-03-03 |
| 1457719239 | Hufford Vision & Eye Care, PC | Optometrist | 560 West Mitchell, Suite 214, Petoskey, MI 49770 | 2016-02-08 |
| 1053779439 | Kaylyn Schiemann | Specialist/Technologist | 1980 Maxwell Rd, Petoskey, MI 49770 | 2016-02-01 |
| 1669839130 | Stieber Pediatric Dentistry Pllc | Clinic/Center | 1605 Us 131 Highway, Petoskey, MI 49770 | 2016-01-28 |
| Find all providers in zip 49770 | ||||
| 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 |
|---|---|---|---|---|
| 1235342866 | Little Traverse Bay Bands of Odawa Indians | Community/Behavioral Health | 101 Greenwood, Petoskey, MI 49770 | 2007-05-08 |
| 1881060549 | North Country Community Mental Health | Community/Behavioral Health | 1420 Plaza Dr, Petoskey, MI 49770-9420 | 2015-08-18 |
| 1821477845 | The Men's Counseling Center of Northern Michigan, LLC | Community/Behavioral Health | 2202 Mitchell Park Dr, Suite 2b, Petoskey, MI 49770-8897 | 2015-05-22 |
| 1275940280 | Susan M. Hoffman | Community/Behavioral Health | 231 State St, Petoskey, MI 49770-2785 | 2014-07-22 |
| 1366760381 | North Country Community Mental Health | Community/Behavioral Health | 1 Macdonald Dr, Suite A, Petoskey, MI 49770-4406 | 2010-05-14 |
| 1053474015 | North Country Community Mental Health | Community/Behavioral Health | 1420 Plaza Dr, Petoskey, MI 49770-9420 | 2006-12-19 |
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| 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 | ||||
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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.