Shanti Counseling Services, LLC

Primary specialty

Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X

License

6801067098 Issued in MI

Legal business name

SHANTI COUNSELING SERVICES, LLC

Practice address

6199 Miller Rd
Suite a
Swartz Creek, MI 48473-1585

Phone

(810) 630-0904

NPI assigned

Dec 13, 2007

Organization subpart

No

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

Authorized official

Name

Theresa Marie Callard-Moore, MSW, ACSW, LMSW

Title

President

Phone

(810) 630-0904

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Theresa Callard-Moore, ACSW Other name

Locations

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

{
    "created_epoch": "1197504000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1197504000000",
    "number": "1174706048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6199 MILLER RD",
            "address_2": "SUITE A",
            "city": "SWARTZ CREEK",
            "state": "MI",
            "postal_code": "484731585",
            "telephone_number": "810-630-0904"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6199 MILLER RD",
            "address_2": "SUITE A",
            "city": "SWARTZ CREEK",
            "state": "MI",
            "postal_code": "484731585",
            "telephone_number": "810-630-0904"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHANTI COUNSELING SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-13",
        "last_updated": "2007-12-13",
        "status": "A",
        "authorized_official_last_name": "CALLARD-MOORE",
        "authorized_official_first_name": "THERESA",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "810-630-0904",
        "authorized_official_credential": "MSW, ACSW, LMSW"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "MI",
            "license": "6801067098",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1235158627",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "8008976950",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Theresa Callard-Moore, ACSW",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Shelby Ruggirello
• Traci Linn Sampson, MA, LLC, NCC
• Kathryn Sands
• Samantha Cameron Schulze
• Amanda Lee Sexton
• Punam Sharman, M.D.
• Sarah Jane Short
• Guneet Kaur Sidhu, O.D.
• Eli Philip Simmons
• Rebecca Elizabeth Smith

• Adult Mental Health Clinic/Center in Swartz Creek, MI
• Providers in Swartz Creek, MI by specialty
• Adult Mental Health Clinic/Center in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2007; 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.