WHITE LAKE SERENITY CENTER, PLLC (NPI# 1700363777) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1700363777 |
| Entity Type | Organization |
| Organization Name | WHITE LAKE SERENITY CENTER, PLLC |
| Practice Address |
8435 Old Channel Trl Montague MI 49437-1360 |
| Mailing Address |
14926 Minetta Ave Spring Lake MI 49456-1100 |
| Practice Telephone | 2315572853 |
| Enumeration Date | 2018-07-23 |
| Last Update Date | 2018-07-23 |
| Authorized Official Name | ELIZABETH PYLE (OWNER) |
| Authorized Official Telephone | 2315572853 |
| Authorized Official Credential | LMSW |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QM0855X |
Clinic/Center Specialization: Adolescent and Children Mental Health |
Ambulatory Health Care Facilities | ||
| Y | 261QM0850X |
Clinic/Center Specialization: Adult Mental Health |
Ambulatory Health Care Facilities |
| Street Address |
8435 OLD CHANNEL TRL |
| City | MONTAGUE |
| State | MI |
| Zip Code | 49437-1360 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538295886 | James M Husiak | Dentist | 8794 Spring Street, Montague, MI 49437 | 2007-02-23 |
| 1467530832 | Barbara Jean Brown | Physical Therapist | 9219 Water Street, Shoreline Rehab, Montague, MI 49437 | 2006-11-01 |
| 1740377548 | Susan Lynn Brufladt | Pharmacist | 8744 Ferry St., Montague, MI 49437 | 2006-10-05 |
| 1639257009 | Marilyn Louise Balgooyen | Physical Therapist | 9219 Water Street, Shoreline Rehab, Montague, MI 49437 | 2006-11-01 |
| 1023485117 | Michelle Ann Anderson | Pharmacy Technician | 9267 Pauline St, Montague, MI 49437-1021 | 2015-08-25 |
| 1629441258 | Joshua Ryder | Prosthetist | 4915 Stanton Blvd, Montague, MI 49437-1039 | 2015-11-04 |
| 1619341567 | West Coast Orthotics and Prosthetics | Prosthetic/Orthotic Supplier | 4915 Stanton Blvd, Montague, MI 49437-1039 | 2015-11-16 |
| 1235611757 | Bellmark Life Coaching | Counselor | 4581 Stanton Blvd, Montague, MI 49437-1060 | 2018-08-31 |
| 1194771824 | David Pastoor | Family Medicine | 4478 Dowling St, Montague, MI 49437-1201 | 2006-05-25 |
| 1083892921 | Prashanti Bishan Sarup Saxena | Physical Therapist | 4478 Dowling St, Montague, MI 49437-1201 | 2008-02-02 |
| Find all providers in zip 49437 | ||||
| Taxonomy Code | 261QM0850X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Adult Mental Health |
| An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in adults. |
| Notes: [7/1/2003: new] |
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| 1316585367 | Valarie James, LLC | Clinic/Center | 1290 36th St Sw, Wyoming, MI 49509-3468 | 2019-12-19 |
| 1306484175 | Joy Counseling Services Pllc | Clinic/Center | 1000 W Maple Rd Ste 108, Troy, MI 48084-5306 | 2019-12-12 |
| 1922646751 | Tranquility Christian Counseling Inc | Clinic/Center | 24100 Southfield Rd Ste 320f, Southfield, MI 48075-2819 | 2019-12-11 |
| 1982241964 | Marquette Counseling Service | Clinic/Center | Lori Johnson, 112 W Washington Street Ste A, Marquette, MI 49855-3844 | 2019-12-09 |
| 1033769534 | Honor First | Clinic/Center | 25801 Harper Ave, Saint Clair Shores, MI 48081-2233 | 2019-09-17 |
| 1871140681 | Modern Family Counseling Center | Clinic/Center | 4195 Barcroft Way, West Bloomfield, MI 48323-1803 | 2019-08-26 |
| 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.