Organization Active NPI

Healthy Minds of Michigan

  • Clinical Social Worker
  • Midland, MI
National Provider Identifier
1053095604
Registry record updated Jul 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
HEALTHY MINDS OF MICHIGAN
Practice address
5103 Eastman Ave Ste 117
Midland, MI 48640-6723
Phone
(989) 455-8214
NPI assigned
Jun 14, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 6, 2023

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

Authorized official

Name
Angela Cilley, LMSWNPI 1376973537
Title
Social Worker
Phone
(989) 455-8214

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 Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X Primary

Addresses

Primary practice location

5103 Eastman Ave Ste 117
Midland, MI 48640-6723

Mailing address

5103 Eastman Ave Ste 117
Midland, MI 48640-6723
Phone (989) 455-8214

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230713001080 MI Part B Supplier - Clinic/Group Practice 5092175729 Receives reassigned benefits from 1 practitioner
Practice locations: Midland, MI

National Provider Directory

National Provider Directory

Locations

5103 Eastman Ave
Ste 117
Midland, MI 48640
Phone (989) 455-8214

Practitioners & affiliated clinicians

Practitioners 1

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": "1686700800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1688601600000",
    "number": "1053095604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5103 EASTMAN AVE STE 117",
            "city": "MIDLAND",
            "state": "MI",
            "postal_code": "486406723",
            "telephone_number": "989-455-8214"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5103 EASTMAN AVE STE 117",
            "city": "MIDLAND",
            "state": "MI",
            "postal_code": "486406723",
            "telephone_number": "989-455-8214"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALTHY MINDS OF MICHIGAN",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-06-14",
        "last_updated": "2023-07-06",
        "certification_date": "2023-07-06",
        "status": "A",
        "authorized_official_last_name": "CILLEY",
        "authorized_official_first_name": "ANGELA",
        "authorized_official_title_or_position": "SOCIAL WORKER",
        "authorized_official_telephone_number": "989-455-8214",
        "authorized_official_credential": "LMSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Midland, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2023; 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.