Black Male Therapist LLC

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

BLACK MALE THERAPIST LLC

Practice address

21650 W 11 Mile Rd Ste 108
Southfield, MI 48076-3715

Phone

(248) 973-7177

NPI assigned

Feb 10, 2021

Last updated

Feb 10, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Steven D Stuckey, LMSWNPI 1003155581

Title

Owner

Phone

(248) 973-7177

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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.

• Steven Stuckey, MSW

  • Social Worker
  • Redford, MI
  • NPI 1003155581
  NPD Authorized official

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

{
    "created_epoch": "1612915200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1612915200000",
    "number": "1194317248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21650 W 11 MILE RD STE 108",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480763715",
            "telephone_number": "248-973-7177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21650 W 11 MILE RD STE 108",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480763715",
            "telephone_number": "248-973-7177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLACK MALE THERAPIST LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-02-10",
        "last_updated": "2021-02-10",
        "certification_date": "2021-02-10",
        "status": "A",
        "authorized_official_last_name": "STUCKEY",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "248-973-7177",
        "authorized_official_credential": "LMSW"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Louis Bitoff Jr., DPM
• Cameron James Bixby, DO
• Mahmoud Bjeijeh, COTA
• Black & White Look Optical Corp
• Black and White Look Optical Corporation
• Sabrina Diana Black, LLPC
• Brittany Denise Blackburn, REGISTERED NURSE
• Edward L Blackburn
• Jason Barry Blackburn, CRNA
• Meloneze Renee Blackman

• Mental Health Clinic/Center (Including Community Mental Health Center) in Southfield, MI
• Providers in Southfield, MI by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2021; 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.