North Country Community Mental Health

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

NORTH COUNTRY COMMUNITY MENTAL HEALTH

Practice address

1420 Plaza Dr
Petoskey, MI 49770-9420

Phone

(231) 439-1233

Fax

(231) 347-1241

NPI assigned

Dec 19, 2006

Last updated

Dec 16, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Alexis Kaczynski

Title

Executive Director

Phone

(231) 347-7890

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Locations

Practitioners 99

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Mindy Sue Binko, LLMSW

  • Mental Health Counselor
  • Gaylord, MI
  • NPI 1780196006
  Medicare reassignment Care Compare group NPD
• Mary Lynn Elizabeth Brown, LMSW

  • Clinical Social Worker
  • Petoskey, MI
  • NPI 1538918107
  Medicare reassignment Care Compare group NPD
• Tamlynn Evans, APRN, BC, NP

  • Psychiatric/Mental Health Nurse Practitioner
  • Traverse City, MI
  • NPI 1336113216
  Medicare reassignment Care Compare group NPD
• John D Gherman, MD

  • Psychiatry Physician
  • Petoskey, MI
  • NPI 1780626788
  Medicare reassignment Care Compare group NPD
• Mary Hotchkiss, LMSW

  • Clinical Social Worker
  • Cheboygan, MI
  • NPI 1962822312
  Medicare reassignment Care Compare group NPD
• Heather Renee Irish, LPC

  • Mental Health Counselor
  • Petoskey, MI
  • NPI 1629752928
  Medicare reassignment Care Compare group NPD
• Tiffany Kiper, LMSW

  • Clinical Social Worker
  • Petoskey, MI
  • NPI 1326730474
  Medicare reassignment Care Compare group NPD
• Julia Alexandra-Saldana Perry, LPC

  • Mental Health Counselor
  • Gaylord, MI
  • NPI 1336611904
  Medicare reassignment Care Compare group NPD
• Natalia Powell, MA, LPC, NCC

  • Mental Health Counselor
  • Petoskey, MI
  • NPI 1700653656
  Medicare reassignment Care Compare group NPD
• Jodie Roback

  • Social Worker
  • Bellaire, MI
  • NPI 1689186744
  Medicare reassignment Care Compare group NPD
• Alan Vern Scott, LMSW

  • Clinical Social Worker
  • Cheboygan, MI
  • NPI 1821138488
  Medicare reassignment Care Compare group NPD
• Joann Servant, DNP,PMHNP-BC,FNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Petoskey, MI
  • NPI 1508295908
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1166486400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1450224000000",
    "number": "1053474015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1420 PLAZA DR",
            "city": "PETOSKEY",
            "state": "MI",
            "postal_code": "497709420",
            "telephone_number": "231-439-1233",
            "fax_number": "231-347-1241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1420 PLAZA DR",
            "city": "PETOSKEY",
            "state": "MI",
            "postal_code": "497709420",
            "telephone_number": "231-439-1233",
            "fax_number": "231-347-1241"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH COUNTRY COMMUNITY MENTAL HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-19",
        "last_updated": "2015-12-16",
        "status": "A",
        "authorized_official_last_name": "KACZYNSKI",
        "authorized_official_first_name": "ALEXIS",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "231-347-7890",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4476072",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4476125",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4476116",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• William Louis Niksch, M.D.
• NMRS, P.C.
• Duane R Nolff, PA-C
• North Bay Ophthalmology, PC
• North Bay Ophthalmology, PC (North Bay Optical)
• North Country Community Mental Health
• North Country Community Mental Health
• Northern Anesthesia Providers PC
• Northern Edge Institute of Rehabilitation
• Northern Family Medicine, PLLC

• Community/Behavioral Health Agency in Petoskey, MI
• Providers in Petoskey, MI by specialty
• Community/Behavioral Health Agency in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2015; 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.