Transitions Wellness Center LLC
Organization Active NPI Psychologist · Three Rivers, MI
NPI 1215155403 · NPPES record last updated Aug 22, 2020
Key facts
- NPI
- 1215155403
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Psychologist 103T00000X
- License
- 6301010838 (MI)
- Legal business name
- TRANSITIONS WELLNESS CENTER LLC
- Practice address
- 16587 Enterprise Dr
Three Rivers, MI 49093-7902 - Phone
- (269) 273-2024
- Fax
- (269) 273-3191
- NPI assigned
- Apr 23, 2007
- Organization subpart
- No
Authorized official
- Name
- Michael R. Ballard
- Title
- Owner
- Phone
- (269) 273-2024
Practitioners 14
-
Paula Andrasi, PSYD
-
Ruth Ann Westfall, LMSW-C
-
John Howie, EDD
-
Paula Renee Kanaan, LMSW
-
Heidi R Olivares, LMSW
-
Jessica Lynn Roy, LPC
-
Alyss Salas, LMSW
-
Kelly Touchtone, LLMSW
-
Jane Turner, LMSW
-
Michael R Ballard, PSYCHOLOGIST
-
Christopher Lee Barnes, PSYD
-
Jacob Keeler, LPC
-
Alexis Siple, PSYD
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MI
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20070619000353 | MI | Part B Supplier - Clinic/Group Practice | 3476652330 |
Receives reassigned benefits from 9 practitioners Practice locations: Three Rivers, MI |
National Provider Directory
Locations
1519 N Main St
Ste C
Three Rivers, MI 49093
Phone (269) 273-2024
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist |
103T00000X | 6301010838 | MI | Yes |
Addresses
Primary practice location
16587 Enterprise Dr
Three Rivers, MI 49093-7902
Mailing address
16587 Enterprise Dr
Three Rivers, MI 49093-7902
Phone (269) 273-2024
NPI Registry JSON
{
"created_epoch": "1177286400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1598054400000",
"number": "1215155403",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16587 ENTERPRISE DR",
"city": "THREE RIVERS",
"state": "MI",
"postal_code": "490937902",
"telephone_number": "269-273-2024",
"fax_number": "269-273-3191"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "16587 ENTERPRISE DR",
"city": "THREE RIVERS",
"state": "MI",
"postal_code": "490937902",
"telephone_number": "269-273-2024",
"fax_number": "269-273-3191"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "TRANSITIONS WELLNESS CENTER LLC",
"organizational_subpart": "NO",
"enumeration_date": "2007-04-23",
"last_updated": "2020-08-22",
"status": "A",
"authorized_official_last_name": "BALLARD",
"authorized_official_first_name": "MICHAEL",
"authorized_official_middle_name": "R.",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "269-273-2024"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Psychologist",
"state": "MI",
"license": "6301010838",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Three Rivers, MI
- Cavanaugh Thuemmel
- Margaret Tilbury
- Barbara J Timby
- Grace Tone
- Kelly Touchtone
- Holly Louise Trapp
- Adam Trisler
- Nitin Udhawani
- Karen Ellen Urbanski
- Usv Optical Inc.
All providers in Three Rivers, MI · Psychologist in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 22, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.