The Behavioral Medicine Clinic of Northwest Michigan, P.C.

Primary specialty

Medical Specialty Clinic/CenterTaxonomy code 261QM2500X

License

4301062201 Issued in MI

Legal business name

THE BEHAVIORAL MEDICINE CLINIC OF NORTHWEST MICHIGAN, P.C.

Practice address

745 S Garfield Ave
Suite C
Traverse City, MI 49686-3479

Phone

(231) 932-1250

Fax

(231) 932-1266

NPI assigned

Dec 18, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Terry M. Dickson, M.D.NPI 1851505978

Title

President

Phone

(231) 932-1250

Specialties & licenses 1

Addresses

Practitioners 1

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

• Terry Marc Dickson, M.D.

  • Developmental - Behavioral Pediatrics Physician
  • Traverse City, MI
  • NPI 1851505978
  NPD (past) Authorized official

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

{
    "created_epoch": "1229558400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1377561600000",
    "number": "1154567279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "745 S GARFIELD AVE",
            "address_2": "SUITE C",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496863479",
            "telephone_number": "231-932-1250",
            "fax_number": "231-932-1266"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "745 S GARFIELD AVE",
            "address_2": "SUITE C",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496863479",
            "telephone_number": "231-932-1250",
            "fax_number": "231-932-1266"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE BEHAVIORAL MEDICINE CLINIC OF NORTHWEST MICHIGAN, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-12-18",
        "last_updated": "2013-08-27",
        "status": "A",
        "authorized_official_last_name": "DICKSON",
        "authorized_official_first_name": "TERRY",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "231-932-1250",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "MI",
            "license": "4301062201",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marcy Terrell
• Teter Orthotics & Prosthetics, Inc
• Sheali Thayer
• Zoey Thayer
• The Apothecary Shoppe Pharmacies, LLC
• The Behavioral Medicine Clinic of Northwest Michigan, PLC
• The Center for Plastic Surgery of Northern Michigan
• The Manor House
• The Maple Clinic of Traverse City, Inc.
• The Maple Clinic, Inc.

• Medical Specialty Clinic/Center in Traverse City, MI
• Providers in Traverse City, MI by specialty
• Medical Specialty Clinic/Center in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2013; 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.