NPIMap

Organization Active NPI

Healing Haven Ancillary Services, LLC

  • Pediatric Occupational Therapist
  • Madison HTS, MI
National Provider Identifier
1063101384
Registry record updated Jan 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Occupational TherapistTaxonomy code 225XP0200X
Legal business name
HEALING HAVEN ANCILLARY SERVICES, LLC
Practice address
30821 Barrington St
Madison HTS, MI 48071-1871
Phone
(248) 965-3916
NPI assigned
May 3, 2023
Last updated
Jan 30, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2025

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

Authorized official

Name
Ms. Jamie McGillivary
Title
Ceo
Phone
(248) 965-3916

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Occupational Therapist 225XP0200X NU Primary
Speech-Language Pathologist 235Z00000X NU

Addresses

Primary practice location

30821 Barrington St
Madison HTS, MI 48071-1871

Mailing address

30821 Barrington St
Madison HTS, MI 48071-1871
Phone (248) 965-3916

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1683072000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1738195200000",
    "number": "1063101384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30821 BARRINGTON ST",
            "city": "MADISON HTS",
            "state": "MI",
            "postal_code": "480711871",
            "telephone_number": "248-965-3916"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30821 BARRINGTON ST",
            "city": "MADISON HTS",
            "state": "MI",
            "postal_code": "480711871",
            "telephone_number": "248-965-3916"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALING HAVEN ANCILLARY SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-05-03",
        "last_updated": "2025-01-30",
        "certification_date": "2025-01-30",
        "status": "A",
        "authorized_official_last_name": "MCGILLIVARY",
        "authorized_official_first_name": "JAMIE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "248-965-3916",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison HTS, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.