NPIMap

Organization Active NPI

Peaceful Banyan

  • Psychologist
  • Plymouth, MI
National Provider Identifier
1194348458
Registry record updated May 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
Legal business name
PEACEFUL BANYAN
Practice address
409 Plymouth Rd Ste 270
Plymouth, MI 48170-1842
Phone
(248) 444-5479
NPI assigned
May 21, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 21, 2020

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

Authorized official

Name
Anne Marie Caldwell, MS LLPNPI 1508984048
Title
Sole Member
Phone
(248) 444-5479

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103T00000X Primary

Addresses

Primary practice location

409 Plymouth Rd Ste 270
Plymouth, MI 48170-1842

Mailing address

409 Plymouth Rd Ste 270
Plymouth, MI 48170-1842
Phone (248) 444-5479

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1590019200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1590019200000",
    "number": "1194348458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "409 PLYMOUTH RD STE 270",
            "city": "PLYMOUTH",
            "state": "MI",
            "postal_code": "481701842",
            "telephone_number": "248-444-5479"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "409 PLYMOUTH RD STE 270",
            "city": "PLYMOUTH",
            "state": "MI",
            "postal_code": "481701842",
            "telephone_number": "248-444-5479"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEACEFUL BANYAN",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-05-21",
        "last_updated": "2020-05-21",
        "certification_date": "2020-05-21",
        "status": "A",
        "authorized_official_last_name": "CALDWELL",
        "authorized_official_first_name": "ANNE MARIE",
        "authorized_official_title_or_position": "SOLE MEMBER",
        "authorized_official_telephone_number": "248-444-5479",
        "authorized_official_credential": "MS LLP"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plymouth, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 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.