NPIMap

Organization Active NPI

Henry Ford Health System

  • Clinical Psychologist
  • Detroit, MI
National Provider Identifier
1114001468
Registry record updated Mar 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
830190 Issued in MI
Legal business name
HENRY FORD HEALTH SYSTEM
Practice address
2799 W Grand Blvd
Detroit, MI 48202-2608
Phone
(313) 916-2600
NPI assigned
Oct 24, 2006
Last updated
Mar 6, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2024

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

Authorized official

Name
Mr. Kelly Ratowski
Title
Director Office of Provider Affairs
Phone
(248) 703-2003

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X
Professional Counselor 101YP2500X
Clinical Neuropsychologist 103G00000X
Clinical Psychologist 103TC0700X 830190 MI Primary

Addresses

Primary practice location

2799 W Grand Blvd
Detroit, MI 48202-2608

Mailing address

2799 W Grand Blvd
Detroit, MI 48202-2608
Phone (313) 916-2600

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031111000517 MI Part B Supplier - Clinic/Group Practice 0547178311 Receives reassigned benefits from 49 practitioners
Practice locations: Detroit, MI

National Provider Directory

National Provider Directory
Tax ID family
Henry Ford Maplegrove Center158 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Locations

1 Ford Pl
#3A
Detroit, MI 48202
Phone (248) 703-1795

1 Ford Pl
Ste 1F
Detroit, MI 48202
Phone (313) 874-4907

10300 W 8 Mile Rd
Ferndale, MI 48220
Phone (248) 398-3200

Ownership & related parties

All facility ownership & control disclosures 26

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Henry Ford Genesys HospitalGrand Blanc, MI, CCN 23T197 Hospital 5% Or Greater Indirect Ownership Interest (100%) Dec 18, 1987
Henry Ford Health Providence Southfield HospitalSouthfield, MI, CCN 230019 Hospital 5% Or Greater Indirect Ownership Interest (100%) Dec 18, 1987
Henry Ford Health Providence Southfield HospitalSouthfield, MI, CCN 23S019 Hospital 5% Or Greater Indirect Ownership Interest (100%) Dec 18, 1987
Henry Ford Health Providence Southfield HospitalSouthfield, MI, CCN 23T019 Hospital 5% Or Greater Indirect Ownership Interest (100%) Dec 18, 1987
Henry Ford Genesys HospitalGrand Blanc, MI, CCN 230197 Hospital 5% Or Greater Indirect Ownership Interest (100%) Dec 18, 1987
Henry Ford Health - St. John HospitalDetroit, MI, CCN 230165 Hospital 5% Or Greater Indirect Ownership Interest (100%) Dec 18, 1987
Henry Ford Health Warren HospitalWarren, MI, CCN 230195 Hospital 5% Or Greater Indirect Ownership Interest (100%) Dec 18, 1987
Henry Ford Health Madison Heights HospitalWarren, MI, CCN 23T195 Hospital 5% Or Greater Indirect Ownership Interest (100%) Dec 18, 1987
Henry Ford Heights Madison Heights HospitalWarren, MI, CCN 23S195 Hospital 5% Or Greater Indirect Ownership Interest (100%) Dec 18, 1987
Henry Ford Health Macomb HospitalClinton Township, MI, CCN 230047 Hospital 5% Or Greater Direct Ownership Interest (100%) Jul 1, 1966
Henry Ford Macomb HospitalClinton Township, MI, CCN 23T047 Hospital 5% Or Greater Direct Ownership Interest (100%) Jul 1, 2007
Henry Ford Health - St. John HospitalDetroit, MI, CCN 23S165 Hospital 5% Or Greater Direct Ownership Interest (100%) Sep 1, 2025
Wyandotte Hospital and Medical CenterWyandotte, MI, CCN 230146 Hospital 5% Or Greater Direct Ownership Interest (100%) Dec 18, 1987
Henry Ford Wyandotte HospitalWyandotte, MI, CCN 23T146 Hospital 5% Or Greater Direct Ownership Interest (100%) Dec 18, 1987
Henry Ford Wyandotte HospitalWyandotte, MI, CCN 23S146 Hospital 5% Or Greater Direct Ownership Interest (100%) Dec 18, 1987
Henry Ford Rochester HospitalRochester, MI, CCN 230254 Hospital 5% Or Greater Indirect Ownership Interest (100%) Dec 18, 1987
Henry Ford Health Rochester HospitalRochester, MI, CCN 23S254 Hospital 5% Or Greater Indirect Ownership Interest (100%) Dec 18, 1987
Henry Ford Health Rochester HospitalRochester, MI, CCN 23T254 Hospital 5% Or Greater Indirect Ownership Interest (100%) Dec 18, 1987
Henry Ford Health Jackson HospitalJackson, MI, CCN 230092 Hospital 5% Or Greater Indirect Ownership Interest (100%) Apr 1, 2016
Henry Ford Health Jackson HospitalJackson, MI, CCN 23S092 Hospital 5% Or Greater Indirect Ownership Interest (100%) Apr 1, 2016
Henry Ford Health Brighton Center for RecoveryBrighton, MI, CCN 230279 Hospital 5% Or Greater Indirect Ownership Interest (100%) Dec 18, 1987
Henry Ford Health River District HospitalEast China, MI, CCN 230241 Hospital 5% Or Greater Direct Ownership Interest (100%) Dec 18, 1987
Henry Ford Health - St. John HospitalDetroit, MI, CCN 23T165 Hospital 5% Or Greater Indirect Ownership Interest (100%) Dec 18, 1987
Henry Ford Health Behavioral Health HospitalWest Bloomfield, MI, CCN 234011 Hospital 5% Or Greater Direct Ownership Interest (17.4%)
General Partnership Interest (17.4%)		 Feb 23, 2025
Feb 23, 2025
Henry Ford Health Jackson HospitalJackson, MI, CCN 237405 Home health agency 5% Or Greater Indirect Ownership Interest (100%) Apr 1, 2016
Henry Ford Allegiance HospiceJackson, MI, CCN 231523 Hospice 5% Or Greater Indirect Ownership Interest (100%) Apr 1, 2016

Practitioners & affiliated clinicians

Practitioners 50

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.

View all 50

NPI Registry JSON

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

{
    "created_epoch": "1161648000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1709683200000",
    "number": "1114001468",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2799 W GRAND BLVD",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482022608",
            "telephone_number": "313-916-2600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2799 W GRAND BLVD",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482022608",
            "telephone_number": "313-916-2600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HENRY FORD HEALTH SYSTEM",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-24",
        "last_updated": "2024-03-06",
        "certification_date": "2024-03-06",
        "status": "A",
        "authorized_official_last_name": "RATOWSKI",
        "authorized_official_first_name": "KELLY",
        "authorized_official_title_or_position": "DIRECTOR OFFICE OF PROVIDER AFFAIRS",
        "authorized_official_telephone_number": "248-703-2003",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "830190",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

Verify at the official NPI Registry.