NPIMap

Organization Active NPI

Hamilton Wellness, PLC

  • Clinical Psychologist
  • Clinton Township, MI
National Provider Identifier
1043798283
Registry record updated Jan 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
6301016232 Issued in MI
Legal business name
HAMILTON WELLNESS, PLC
Practice address
16931 19 Mile Rd Ste 140
Clinton Township, MI 48038-4841
Phone
(586) 226-2822
Fax
(586) 226-2833
NPI assigned
Jul 31, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2021

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

Authorized official

Name
Dr. Maria Tsitsis Aretakis, LPNPI 1235321324
Title
Licensed Psychologist, Co-Owner
Phone
(586) 226-2822

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC0700X 6301016232 MI Primary

Addresses

Primary practice location

16931 19 Mile Rd Ste 140
Clinton Township, MI 48038-4841

Mailing address

16931 19 Mile Rd Ste 140
Clinton Township, MI 48038-4841
Phone (586) 226-2822

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190703000373 MI Part B Supplier - Clinic/Group Practice 6901130459 Receives reassigned benefits from 7 practitioners
Practice locations: Clinton Township, MI

National Provider Directory

National Provider Directory

Locations

16931 19 Mile Rd
Ste 140
Clinton Twp, MI 48038
Phone (586) 226-2822

Practitioners & affiliated clinicians

Practitioners 8

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

NPI Registry JSON

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

{
    "created_epoch": "1532995200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1611187200000",
    "number": "1043798283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16931 19 MILE RD STE 140",
            "city": "CLINTON TOWNSHIP",
            "state": "MI",
            "postal_code": "480384841",
            "telephone_number": "586-226-2822",
            "fax_number": "586-226-2833"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16931 19 MILE RD STE 140",
            "city": "CLINTON TOWNSHIP",
            "state": "MI",
            "postal_code": "480384841",
            "telephone_number": "586-226-2822",
            "fax_number": "586-226-2833"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HAMILTON WELLNESS, PLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-07-31",
        "last_updated": "2021-01-21",
        "certification_date": "2021-01-21",
        "status": "A",
        "authorized_official_last_name": "ARETAKIS",
        "authorized_official_first_name": "MARIA",
        "authorized_official_middle_name": "TSITSIS",
        "authorized_official_title_or_position": "LICENSED PSYCHOLOGIST, CO-OWNER",
        "authorized_official_telephone_number": "586-226-2822",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "LP"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6301016232",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clinton Township, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2021; 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.