NPIMap

Organization Active NPI

Mind and Body Holistic Therapy

  • School Social Worker
  • Detroit, MI
National Provider Identifier
1083990485
Registry record updated Oct 30, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
School Social WorkerTaxonomy code 1041S0200X
License
6801085560 Issued in MI
Legal business name
MIND AND BODY HOLISTIC THERAPY
Practice address
440 Burroughs St.
Detroit, MI 48202
Phone
(313) 422-3109
NPI assigned
Oct 30, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2011

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

Authorized official

Name
Sharifa Harvey, LMSW-SSWNPI 1528299617
Title
Ceo/Clinical Director
Phone
(313) 422-3109

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X 6801085560 MI
School Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041S0200X 6801085560 MI Primary

Addresses

Primary practice location

440 Burroughs St.
Detroit, MI 48202

Mailing address

29 Massachusetts St
Highland Park, MI 48203
Phone (313) 422-3109

National Provider Directory

National Provider Directory

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": "1319932800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1319932800000",
    "number": "1083990485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29 MASSACHUSETTS ST",
            "city": "HIGHLAND PARK",
            "state": "MI",
            "postal_code": "48203",
            "telephone_number": "313-422-3109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "440 BURROUGHS ST.",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "48202",
            "telephone_number": "313-422-3109"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIND AND BODY HOLISTIC THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-10-30",
        "last_updated": "2011-10-30",
        "status": "A",
        "authorized_official_last_name": "HARVEY",
        "authorized_official_first_name": "SHARIFA",
        "authorized_official_title_or_position": "CEO/CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "313-422-3109",
        "authorized_official_credential": "LMSW-SSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801085560",
            "primary": false
        },
        {
            "code": "1041S0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, School",
            "state": "MI",
            "license": "6801085560",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2011; 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.