Great Lakes Teletherapy

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

GREAT LAKES TELETHERAPY

Practice address

707 W Liberty St
Ann Arbor, MI 48103-4348

Phone

(734) 224-3773

NPI assigned

Sep 17, 2020

Organization subpart

No

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

Authorized official

Name

Mrs. Leah R Brock, LMSWNPI 1023453859

Title

Psychotherapist

Phone

(734) 224-3773

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.

• Leah Rebecca Brock, MSW

  • Clinical Social Worker
  • Ann Arbor, MI
  • NPI 1023453859
  NPD Authorized official

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

{
    "created_epoch": "1600300800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1600300800000",
    "number": "1174139968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "707 W LIBERTY ST",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481034348",
            "telephone_number": "734-224-3773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "707 W LIBERTY ST",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481034348",
            "telephone_number": "734-224-3773"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREAT LAKES TELETHERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-17",
        "last_updated": "2020-09-17",
        "certification_date": "2020-09-17",
        "status": "A",
        "authorized_official_last_name": "BROCK",
        "authorized_official_first_name": "LEAH",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PSYCHOTHERAPIST",
        "authorized_official_telephone_number": "734-224-3773",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LMSW"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sommer Ann Marie Gray
• Steven Allen Gray, DDS
• Gregory P. Graziano, MD
• Great Lakes Bay Health Centers
• Great Lakes Oral Surgery PLLC
• Great Lakes Wellness Group
• Jennifer R Greca, M.A. CCC-SLP
• Christina Krokosky Grech, M.D.
• John Anthony Greco, MD
• Patricia Stephanie Greco, M.D.

• Community/Behavioral Health Agency in Ann Arbor, MI
• Providers in Ann Arbor, MI by specialty
• Community/Behavioral Health Agency in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2020; 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.