MICHIGAN MENTAL WELLNESS PLLC (NPI# 1568817021) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568817021 |
| Entity Type | Organization |
| Organization Name | MICHIGAN MENTAL WELLNESS PLLC |
| Practice Address |
37935 W 12 Mile Rd Suite A Farmington Hills MI 48331-6101 |
| Practice Telephone | 3134083006 |
| Mailing Telephone | 3134083006 |
| Enumeration Date | 2016-05-03 |
| Last Update Date | 2016-05-03 |
| Authorized Official Name | DR. PATRICK GRESHAM (OWNER) |
| Authorized Official Telephone | 3134083006 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
5315058344 | MI | Allopathic & Osteopathic Physicians |
| Y | 2084P0804X |
Psychiatry & Neurology Specialization: Child & Adolescent Psychiatry |
5315058344 | MI | Allopathic & Osteopathic Physicians |
| Street Address |
37935 W 12 MILE RD SUITE A |
| City | FARMINGTON HILLS |
| State | MI |
| Zip Code | 48331-6101 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225690795 | Jaime N Janiec | Counselor | 37935 W 12 Mile Rd, Farmington Hills, MI 48331-3035 | 2019-07-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700352804 | Lori A Galicki | Occupational Therapist | 3405 W 12 Mile Rd. Suite 200, Farmington Hills, MI 48331 | 2018-10-17 |
| 1700372877 | Brooke Breann Reed | Speech-Language Pathologist | 34505 W 12 Mile Rd Ste 210, Farmington Hills, MI 48331 | 2018-07-02 |
| 1215473848 | Devon Caroline Welling | Advanced Practice Midwife | 31000 Country Bluff, Farmington Hills, MI 48331 | 2017-01-06 |
| 1780040246 | Pamela Moraa Obare | Nurse Practitioner | 36839 Greenspring St, Farmington Hills, MI 48331 | 2016-01-13 |
| 1427429844 | Counseling for The Brain, Body and Spirit, LLC | Community/Behavioral Health | 36510 Twelve Mile Rd, Farmington Hills, MI 48331 | 2015-10-12 |
| 1538548458 | Shavohn Rowser | Durable Medical Equipment & Medical Supplies | 38657 Lancaster Dr, Farmington Hills, MI 48331 | 2015-05-26 |
| 1851727697 | Sidney Lawrence Stone | Ophthalmology | 28853 Nottoway Drive, Farmington Hills, MI 48331 | 2013-09-25 |
| 1659621159 | Jacqueline Kiernan | Physical Therapist | 27240 Haggarty, Suite E15, Farmington Hills, MI 48331 | 2012-09-12 |
| 1770876476 | Elizabeth Anne Clancy | Counselor | 37875 12 Mile Rd, Farmington Hill, MI 48331 | 2011-05-27 |
| 1902197833 | Carla's Companionship & Care LLC | Home Health | 31145 Floralview Dr. S. #207, Farmington Hills, MI 48331 | 2011-04-26 |
| Find all providers in zip 48331 | ||||
| Taxonomy Code | 2084P0804X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Child & Adolescent Psychiatry |
| Child & Adolescent Psychiatry is a subspecialty of psychiatry with additional skills and training in the diagnosis and treatment of developmental, behavioral, emotional, and mental disorders of childhood and adolescence. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851515506 | Linda Christine Speck | Psychiatry & Neurology | 37875 W 12 Mile Rd, Suite 220, Farmington Hills, MI 48331-3043 | 2007-04-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316376056 | Esmaeil Emami | Psychiatry & Neurology | 2955 Franklin Rd, Bloomfield Hills, MI 48302-0917 | 2013-11-04 |
| 1154760312 | Samantha Fugate Kennedy | Psychiatry & Neurology | 909 Fee Rd Ste B119, East Lansing, MI 48824 | 2013-06-21 |
| 1407199961 | David Donald Krohn | Psychiatry & Neurology | 563 Highland Park Dr, Traverse City, MI 49686-2863 | 2013-04-03 |
| 1164712055 | Tatjana Maric | Psychiatry & Neurology | 420 Baltimore Dr Ne, Grand Rapids, MI 49503-3934 | 2011-04-12 |
| 1972893824 | Katherine Barbara Krive | Psychiatry & Neurology | 801 S Waverly Rd Ste 100, Lansing, MI 48917-4200 | 2011-04-12 |
| 1104128602 | Hope Network Behavioral Health Services | Psychiatry & Neurology | 3361 36th Street, Grand Rapids, MI 49512 | 2010-12-03 |
| 1295056653 | Veronica Yap Tan | Psychiatry & Neurology | 23354 Portage Way, Apt. 2212, Novi, MI 48375 | 2010-06-18 |
| 1548588874 | Katie Alanna Keller | Psychiatry & Neurology | 79 Alexandrine West, Detroit, MI 48201 | 2010-05-11 |
| 1538390133 | Behavioral Health Associates Pllc | Psychiatry & Neurology | 19500 Middlebelt Rd, Suite 350e, Livonia, MI 48152-2196 | 2009-07-30 |
| 1235375775 | Kristine Baker | Psychiatry & Neurology | 721 Cherokee St, Traverse City, MI 49684-1401 | 2009-01-06 |
| Find all providers with the same taxonomy | ||||
| City | FARMINGTON HILLS |
| Zip Code | 48331 |
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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.