In Peace Counseling Services LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6801077738 Issued in MI

Legal business name

IN PEACE COUNSELING SERVICES LLC

Practice address

30400 Telegraph Rd
Suite 331
Bingham Farms, MI 48025-4537

Phone

(248) 645-5960

Fax

(248) 645-0562

NPI assigned

Aug 17, 2010

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mikayla Tanner, LMSWNPI 1487859005

Title

Owner

Phone

(248) 645-5960

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Mikayla Linsalata Tanner, LMSW

  • Clinical Social Worker
  • West Bloomfield, MI
  • NPI 1487859005
  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1282003200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1461801600000",
    "number": "1033424874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30400 TELEGRAPH RD",
            "address_2": "SUITE 331",
            "city": "BINGHAM FARMS",
            "state": "MI",
            "postal_code": "480254537",
            "telephone_number": "248-645-5960",
            "fax_number": "248-645-0562"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30400 TELEGRAPH RD",
            "address_2": "SUITE 331",
            "city": "BINGHAM FARMS",
            "state": "MI",
            "postal_code": "480254537",
            "telephone_number": "248-645-5960",
            "fax_number": "248-645-0562"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IN PEACE COUNSELING SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-08-17",
        "last_updated": "2016-04-28",
        "status": "A",
        "authorized_official_last_name": "TANNER",
        "authorized_official_first_name": "MIKAYLA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "248-645-5960",
        "authorized_official_credential": "LMSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801077738",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in Bingham Farms, MI
• Providers in Bingham Farms, MI by specialty
• Clinical Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.