CENTER FOR BRAINWAVE BALANCE PLLC (NPI# 1588091409) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1588091409 |
| Entity Type | Organization |
| Organization Name | CENTER FOR BRAINWAVE BALANCE PLLC |
| Practice Address |
2245 S State St Suite 1200 #1a Ann Arbor MI 48104-6184 |
| Practice Telephone | 7345850952 |
| Practice Fax Number | 7345850954 |
| Mailing Telephone | 7345850952 |
| Mailing Fax Number | 7345850954 |
| Enumeration Date | 2013-10-09 |
| Last Update Date | 2014-02-06 |
| Authorized Official Name | DR. DEBRA HUTTON (CLINICAL PSYCHOLOGIST/PRESIDENT) |
| Authorized Official Telephone | 7345850952 |
| Authorized Official Credential | PH.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103T00000X | Psychologist | 5261 | OH | Behavioral Health & Social Service Providers |
| Street Address |
2245 S STATE ST SUITE 1200 #1A |
| City | ANN ARBOR |
| State | MI |
| Zip Code | 48104-6184 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154540961 | Total Care Home Health Care, Inc. | Home Health | 2245 S State St, # 100, Ann Arbor, MI 48104-6184 | 2007-04-24 |
| 1336615467 | Elizabeth Derby Sammons Rodems | Social Worker | 2245 S State St, Ann Arbor, MI 48104-6184 | 2018-10-16 |
| 1295255990 | Julia Kessler-hollar | Social Worker | 2245 S State St, Ann Arbor, MI 48104-6184 | 2017-06-23 |
| 1689075285 | Jewish Family Services of Washtenaw County, Inc | Counselor | 2245 S State St, Suite 200, Ann Arbor, MI 48104-6184 | 2014-09-15 |
| 1689099947 | Sarah Hong | Social Worker | 2245 S State St, Ste 200, Ann Arbor, MI 48104-6184 | 2014-02-24 |
| 1285064360 | Morgan Deleonard | Social Worker | 2245 S State St, Ste. 200, Ann Arbor, MI 48104-6184 | 2013-11-26 |
| 1598006637 | Diane Lynn Fenske | Counselor | 2245 S State St, Suite 200, Ann Arbor, MI 48104-6184 | 2013-03-14 |
| 1235402777 | Mira Shlomit Sussman | Social Worker | 2245 S State St, Suite 200, Ann Arbor, MI 48104-6184 | 2012-02-14 |
| 1932484177 | Joanna Rosenthal | Social Worker | 2245 S State St, Ann Arbor, MI 48104-6184 | 2011-10-19 |
| 1861790503 | Laura Jacobs Davie | Counselor | 2245 S State St, Ann Arbor, MI 48104-6184 | 2011-03-04 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336603927 | Julie Corey | Counselor | 2604 Brockman Blvd, Ann Arbor, MI 48104 | 2019-01-28 |
| 1003301045 | Ann Arbor Pharmacy LLC | Pharmacy | 2418 E Stadium Blvd, Ann Arbor, MI 48104 | 2018-06-22 |
| 1811499304 | Melissa L Wright | Physical Therapist | 2850 S Industrial Hwy Suite 200, Ann Arbor, MI 48104 | 2018-03-01 |
| 1689180226 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 3500 Washtenaw Ave Ste E3, Ann Arbor, MI 48104 | 2017-12-19 |
| 1861911547 | Jonathen Ross | Social Worker | 500 E. Washington St., Ste 100a, Ann Arbor, MI 48104 | 2017-09-14 |
| 1275058521 | Emily Lauren Hanna | Social Worker | 214 S. Main Street, Suite # 206, Ann Arbor, MI 48104 | 2017-08-08 |
| 1073035457 | Raynaldo Juaquin Valdez | Specialist/Technologist | 500 E. Hoover Ave, Ann Arbor, MI 48104 | 2017-07-07 |
| 1912436908 | Alison Nicole Tseng | Dentist | 2301 Platt Rd Ste 200, Ann Arbor, MI 48104 | 2017-06-05 |
| 1528593183 | Hillary Baldwin Steller, Lmsw,llc | Social Worker | 715-717 E. Huron St, Suite 2e, Ann Arbor, MI 48104 | 2017-04-20 |
| 1013360973 | Teresa Myers | Massage Therapist | 2230 Washtenaw Ave, Suite 101, Ann Arbor, MI 48104 | 2016-07-15 |
| Find all providers in zip 48104 | ||||
| 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 |
|---|---|---|---|---|
| 1932700036 | Estela M Rivero | Psychologist | 2627 Oak Valley Dr Apt 205, Ann Arbor, MI 48103-7705 | 2020-11-04 |
| 1073112355 | Sarah Nicole Kesler | Psychologist | 230 Collingwood St Ste 250, Ann Arbor, MI 48103-3845 | 2020-10-19 |
| 1013556174 | Sandra K Kriegish | Psychologist | 2680 Lookout Cir, Ann Arbor, MI 48104-6652 | 2020-01-06 |
| 1730728718 | Alexander Jendrusina | Psychologist | Va Ann Arbor Healthcare System, 2215 Fuller Rd, Ann Arbor, MI 48105 | 2019-12-23 |
| 1144868456 | Beth Kafkakis Ma LLP LLC | Psychologist | 2010 Hogback Rd Ste 6d, Ann Arbor, MI 48105-8800 | 2019-12-17 |
| 1356814115 | Ian Gackowski | Psychologist | 120 E Liberty St Ste 300d, Ann Arbor, MI 48104-2163 | 2019-01-04 |
| 1538671250 | Miea Moon | Psychologist | 3200 E Eisenhower Parkway, Moriah Hall, Ann Arbor, MI 48108 | 2017-11-03 |
| 1992258560 | Frederick Warren Upton | Psychologist | 635 S Maple Rd # 2, Ann Arbor, MI 48103 | 2016-07-29 |
| 1003267329 | Junichi Shimaoka | Psychologist | 1316 Packard St Apt 2, Ann Arbor, MI 48104-3816 | 2016-06-28 |
| 1174988646 | Kristin Marie Rispoli | Psychologist | 300 N 5th Ave, Suite 210, Ann Arbor, MI 48104-5504 | 2015-12-28 |
| Find all providers in ANN ARBOR | ||||
Please comment or provide details below to improve the information on CENTER FOR BRAINWAVE BALANCE PLLC.
| 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.