BLUE PEARL WELLNESS, PLLC (NPI# 1578117990) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578117990 |
| Entity Type | Organization |
| Organization Name | BLUE PEARL WELLNESS, PLLC |
| Practice Address |
17344 W 12 Mile Rd Ste 205 Southfield MI 48076-6321 |
| Mailing Address |
13116 Balfour Ave Huntington Woods MI 48070-1701 |
| Practice Telephone | 2489902722 |
| Mailing Telephone | 2482006061 |
| Enumeration Date | 2019-07-25 |
| Last Update Date | 2019-07-25 |
| Authorized Official Name | MANJULA KAZA-EGAN (PRACTITIONER) |
| Authorized Official Telephone | 2482006061 |
| Authorized Official Credential | LMSW |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1041C0700X |
Social Worker Specialization: Clinical |
Behavioral Health & Social Service Providers |
| Other Name | Type Code |
|---|---|
| Manjula Egan, LMSW | Doing Business As Name - Organization |
| Street Address |
17344 W 12 MILE RD STE 205 |
| City | SOUTHFIELD |
| State | MI |
| Zip Code | 48076-6321 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942813753 | Elaine Sarah Kahn | Social Worker | 15999 West Twelve Mile Rd, Southfield, MI 48076 | 2020-08-31 |
| 1295353829 | Marian Hannah Ibrahim | Dentist | 19189 W 12 Mile Rd, Lathrup Village, MI 48076 | 2020-07-09 |
| 1699317669 | Meadow Lane Rehabilitative Therapies LLC | Social Worker | 29895 Greenfield Rd., Suite 104b, Southfield, MI 48076 | 2019-10-11 |
| 1760035752 | Taliah Laneice Williams-hunter | Counselor | 30119 Sparkleberry Dr., Southfield, MI 48076 | 2019-07-19 |
| 1386114742 | Mavis Gail Pookrum | Technician | 21732 Colony Park Circle #105, Southfield, MI 48076 | 2018-11-28 |
| 1861962417 | Millennial Infusion Centers Inc | Clinic/Center | 26250 Northwestern Hwy Ste 201, Southfield, MI 48076 | 2018-11-27 |
| 1215429212 | Debra Deanes | Counselor | 30233 Southfiels Rd, 203, Southfield, MI 48076 | 2018-06-05 |
| 1437675758 | Kenneth Gerard Giles | Counselor | 29532 Southfield Rd. Suite 208, Southfield, MI 48076 | 2017-08-17 |
| 1902346836 | Linsk Psychiatry Services P C | Clinic/Center | 21751 W 12 Mile Rd, Suite 205, Southfield, MI 48076 | 2017-02-25 |
| 1023552361 | Massage Serenity | Community/Behavioral Health | 20245 W. 12 Mile Rd, Suite 113, Southfield, MI 48076 | 2016-12-06 |
| Find all providers in zip 48076 | ||||
| Taxonomy Code | 1041C0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Social Worker |
| Specialization | Clinical |
| A social worker who holds a master’s or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master’s supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances. |
| Notes: Source: National Association of Social Workers, 2008 [7/1/2009: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942813753 | Elaine Sarah Kahn | Social Worker | 15999 West Twelve Mile Rd, Southfield, MI 48076 | 2020-08-31 |
| 1477162592 | Happy Mama Counseling Pllc | Social Worker | 28250 Franklin Rd Ste B, Southfield, MI 48034-1659 | 2020-07-24 |
| 1427672864 | Brittaneyrose Shelton | Social Worker | 29551 Greenfield Rd Ste 209, Southfield, MI 48076-5872 | 2020-06-01 |
| 1740802750 | Sonya Coleman | Social Worker | 29050 Lancaster Dr Apt 108, Southfield, MI 48034-1436 | 2020-05-13 |
| 1639700131 | Building Connections Senior Center, LLC | Social Worker | 20755 Greenfield Rd Ste 107, Southfield, MI 48075-5400 | 2020-02-03 |
| 1659901783 | Detroit Counseling and Wellness Solutions | Social Worker | 17250 W 12 Mile Rd Ste 213, Southfield, MI 48076-2123 | 2020-01-16 |
| 1699317669 | Meadow Lane Rehabilitative Therapies LLC | Social Worker | 29895 Greenfield Rd., Suite 104b, Southfield, MI 48076 | 2019-10-11 |
| 1760032163 | Christina Finelli | Social Worker | 17515 W 9 Mile Rd Ste 345, Southfield, MI 48075-4403 | 2019-09-17 |
| 1326697574 | Sara Michelle Abrin | Social Worker | 17320 W 12 Mile Rd Ste 101, Southfield, MI 48076-2102 | 2019-09-10 |
| 1033778725 | Kristal Patrice Hunt | Social Worker | 29501 Greenfield Rd Ste 124, Southfield, MI 48076-2250 | 2019-06-06 |
| Find all providers in SOUTHFIELD | ||||
| City | SOUTHFIELD |
| Zip Code | 48076 |
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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.