The Nelson Center for Mindful Synergy

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

THE NELSON CENTER FOR MINDFUL SYNERGY

Practice address

517 Ardmore Dr
Ferndale, MI 48220-3321

Phone

(313) 903-3955

NPI assigned

Jun 27, 2022

Organization subpart

No

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

Authorized official

Name

Jennifer Rose Humphreys, LLMSWNPI 1861680456

Title

President/Ceo

Phone

(313) 903-3955

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

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

• Jennifer Rose Humphreys, MSW

  • Social Worker
  • Southfield, MI
  • NPI 1861680456
  NPD Authorized official

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

{
    "created_epoch": "1656288000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1656288000000",
    "number": "1083346225",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "517 ARDMORE DR",
            "city": "FERNDALE",
            "state": "MI",
            "postal_code": "482203321",
            "telephone_number": "313-903-3955"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "517 ARDMORE DR",
            "city": "FERNDALE",
            "state": "MI",
            "postal_code": "482203321",
            "telephone_number": "313-903-3955"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE NELSON CENTER FOR MINDFUL SYNERGY",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-06-27",
        "last_updated": "2022-06-27",
        "certification_date": "2022-06-27",
        "status": "A",
        "authorized_official_last_name": "HUMPHREYS",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "ROSE",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "313-903-3955",
        "authorized_official_credential": "LLMSW"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1861680456",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lawrence Jude Tantay, LLMSW
• Priscilla Taylor, MS, LLP
• Beatrice Terrell
• Olena Tetyuk, LLP
• The Imperial Elite LLC
• The Nutrition Collective L.L.C.
• Therapeutic Lifestyle Changes, Inc (Healthy U)
• Therapy Management Enterprises Inc.
• Alex Jordan Thomas
• Kelsie Marissa Thorne, M.S.

• Mental Health Clinic/Center (Including Community Mental Health Center) in Ferndale, MI
• Providers in Ferndale, MI by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2022; 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.