BEHAVIORAL MEDICINE ASSOCIATES OF MID MICHIGAN PC (NPI# 1740370089) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1740370089 |
| Entity Type | Organization |
| Organization Name | BEHAVIORAL MEDICINE ASSOCIATES OF MID MICHIGAN PC |
| Practice Address |
1205 E Wackerly St Midland MI 48642-7035 |
| Practice Telephone | 9898329161 |
| Practice Fax Number | 9898328813 |
| Mailing Telephone | 9898329161 |
| Mailing Fax Number | 9898328813 |
| Enumeration Date | 2006-10-16 |
| Last Update Date | 2014-12-04 |
| Authorized Official Name | DR. LYNN ELAINE SIMONS (DIRECTOR) |
| Authorized Official Telephone | 9898329161 |
| Authorized Official Credential | PSY.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MEDICARE PTAN | 0P36530 | 01 |
| Street Address |
1205 E WACKERLY ST |
| City | MIDLAND |
| State | MI |
| Zip Code | 48642-7035 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659989705 | Jeffery Deitrick | Counselor | 1205 E Wackerly St, Midland, MI 48642-7035 | 2020-07-15 |
| 1396279162 | Travis J. Pashak | Psychologist | 1205 E Wackerly St, Midland, MI 48642-7035 | 2017-04-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609488378 | Costco Wholesale Corporation | Eyewear Supplier (Equipment, not the service) | 4816 Bay City Rd, Midland, MI 48642 | 2020-08-23 |
| 1033762166 | Landon Reed | Occupational Therapist | 5600 Waldo Ave, Midland, MI 48642 | 2019-07-17 |
| 1609436062 | Rostam Adult and Pediatric Medicine Midland Pllc | Family Medicine | 801 Joe Mann Blvd, Suite H, Midland, MI 48642 | 2019-06-18 |
| 1194295758 | Shirley Curtiss | Behavior Technician | 3301 Ridgecrest Drive, Midland, MI 48642 | 2018-11-27 |
| 1396264768 | Emily Lipa | Behavior Technician | 3301 Ridgecrest Dr., Midland, MI 48642 | 2017-09-16 |
| 1366982381 | Alison Bressette | Behavior Technician | 337 Lemke St, Midland, MI 48642 | 2017-02-24 |
| 1376926162 | Aba Connections of Central Michigan, LLC | Behavioral Analyst | 3301 Ridecrest Dr, Midland, MI 48642 | 2015-06-30 |
| 1952724130 | Rachelle Mott | Registered Nurse | 218 Fast Ice Dr., Midland, MI 48642 | 2014-01-24 |
| 1407123482 | Community Mental Health for Central Michigan | Community/Behavioral Health | 218 Fast Ice Drive, Midland, MI 48642 | 2011-11-19 |
| 1225283534 | Audio-aid Rx | Hearing Aid Equipment | 6855 N. Eastman Ave., Midland, MI 48642 | 2008-12-01 |
| Find all providers in zip 48642 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225585847 | Paula Shantel Alexis Mackey | Psychologist | 3309 Haynes Ave, Midland, TX 79707-3600 | 2016-09-01 |
| 1326212168 | Teresa Jean Lynch | Psychologist | 1717 E Sugnet Rd, Midland, MI 48642-3827 | 2008-04-14 |
| 1528251097 | Tracey M Allan | Psychologist | 211 N Saginaw Rd, Midland, MI 48640-3350 | 2007-08-19 |
| 1700086634 | Henry Chiyung Chung | Psychologist | 3115 Dawn Dr, Midland, MI 48642-4026 | 2007-07-19 |
| 1336281096 | Joseph Lloyd Tierney | Psychologist | 607 Gordon St, Midland, MI 48640 | 2007-02-12 |
| 1063501351 | Nicole Lynn Minnis | Psychologist | 218 Fast Ice Dr, Midland, MI 48642-6167 | 2006-10-12 |
| 1871693481 | Jennifer Anne Lombardo | Psychologist | 104 W Wackerly St, Midland, MI 48640-2791 | 2006-09-24 |
| 1154338754 | Bart Eugene Barto | Psychologist | 10112 W County Road 54, Midland, TX 79707-1319 | 2006-08-03 |
| 1457321291 | Lynn Elaine Simons | Psychologist | 1108 Ashman St, Midland, MI 48640-5470 | 2006-01-24 |
| 1245889369 | Elizabeth Zimmermann | Psychologist | 720 W Wackerly St, Midland, MI 48640-2769 | 2019-09-11 |
| Find all providers in MIDLAND | ||||
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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.