OTTENBREIT PSYCHOTHERAPY ASSOCIATES, LLC (NPI# 1639621857) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639621857 |
| Entity Type | Organization |
| Organization Name | OTTENBREIT PSYCHOTHERAPY ASSOCIATES, LLC |
| Practice Address |
835 Mason St B-200 Dearborn MI 48124-2231 |
| Practice Telephone | 3135756297 |
| Practice Fax Number | 3134064617 |
| Mailing Telephone | 3135756297 |
| Mailing Fax Number | 3134064617 |
| Enumeration Date | 2016-11-04 |
| Last Update Date | 2016-12-05 |
| Authorized Official Name | MR. BRUCE D. OTTENBREIT (CLINICAL SOCIAL WORKER) |
| Authorized Official Telephone | 3135756297 |
| Authorized Official Credential | LMSW, ASCW |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1041C0700X |
Social Worker Specialization: Clinical |
MSW-6801007603 | MI | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| QAQH | 12313056 | 01 |
| Street Address |
835 MASON ST B-200 |
| City | DEARBORN |
| State | MI |
| Zip Code | 48124-2231 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952730624 | Sanaa Nadim Haidar | Counselor | 835 Mason St, Dearborn, MI 48124-2231 | 2013-11-04 |
| 1427655794 | Sierra Rachelle Hill | Psychologist | 835 Mason St, Dearborn, MI 48124-2231 | 2020-10-08 |
| 1720568694 | Jordan Mosley | Psychologist | 835 Mason St, Dearborn, MI 48124-2231 | 2018-08-20 |
| 1447701255 | Michigan Modern Psychology Group,pllc | Psychologist | 835 Mason St, Suite B 220, Dearborn, MI 48124-2231 | 2016-10-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396389524 | Pharma A, LLC | Pharmacy | 23916 Michigan Ave, Dearborn, MI 48124 | 2019-10-31 |
| 1225683725 | Aysha Said | Behavior Technician | 1369 Porter St, Dearborn, MI 48124 | 2019-08-02 |
| 1881257772 | Leen Nusairat | Internal Medicine | Beaumont Health-dearborn Campus, 18101 Oakwood Blvd, Dearborn, MI 48124 | 2019-04-17 |
| 1417413360 | Gary C. Veraghen, Dds, PC | Dentist | 22100 W. Outer Drive, Dearborn, MI 48124 | 2019-02-15 |
| 1982168787 | Fnu Asma Manzar | Physical Therapist | Global Physical Therapy Services, Inc, 22819 Michigan Avenue, Dearborn, MI 48124 | 2019-01-25 |
| 1639640162 | Jernia Lashawn Usher | Behavior Technician | 1360 Porter St Lower Level, Dearborn, MI 48124 | 2018-12-10 |
| 1710456470 | Samar Fouad Hannawi | Psychologist | 3815 Pelham Street, Suite #13, Dearborn, MI 48124 | 2018-11-24 |
| 1881178747 | Sarah Chehab | Psychologist | 835 Mason St Suite 220b, Dearborn, MI 48124 | 2018-09-17 |
| 1568948289 | Ibrahim M Basma | Pharmacist | 22521 Michigan Avenue, Dearborn, MI 48124 | 2018-07-16 |
| 1669961942 | Jacqueline E Domzalski | Technician, Other | 3231 S. Gulley, Suite E, Dearborn, MI 48124 | 2018-05-02 |
| Find all providers in zip 48124 | ||||
| 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 |
|---|---|---|---|---|
| 1861953432 | Hoberman Clinic | Social Worker | 1800 Grindley Park St Ste 3, Dearborn, MI 48124-2553 | 2019-03-27 |
| 1073078119 | Zaynab Boussi | Social Worker | 15 Snow Ct, Dearborn, MI 48124-4138 | 2019-02-03 |
| 1639678626 | Kayla Strong | Social Worker | 1 Parklane Blvd Ste 200e, Dearborn, MI 48126-2400 | 2018-02-06 |
| 1750892337 | Asd Latinos Unlimited LLC | Social Worker | 6275 Schaefer Rd Ste 105, Dearborn, MI 48126-2210 | 2017-10-23 |
| 1437672524 | Margaret Chen | Social Worker | 15350 N Commerce Dr Ste 204, Dearborn, MI 48120-1234 | 2017-07-20 |
| 1417483546 | Joan Marie Mckenna | Social Worker | 24110 Cherry Hill Road, Dearborn, MI 48124-1356 | 2017-05-10 |
| 1881059772 | Paul Hardin | Social Worker | 4626 Bingham St, Dearborn, MI 48126-4018 | 2015-12-21 |
| 1124483185 | Laura Malek Beydoun | Social Worker | 4826 Maddie Ln, Dearborn, MI 48126-4173 | 2015-12-17 |
| 1760889935 | Daniel Conroy | Social Worker | 3309 Salina St, Unit 13, Dearborn, MI 48120-1450 | 2014-12-03 |
| 1629323985 | Rebecca Feinstein | Social Worker | 835 Mason St Ste B310, Dearborn, MI 48124-2231 | 2012-07-23 |
| Find all providers in DEARBORN | ||||
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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.