Complete Ketamine Inc

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

COMPLETE KETAMINE INC

Practice address

98 Winchester St
Monroe, MI 48161-1957

Phone

(734) 731-9500

NPI assigned

Jan 28, 2020

Organization subpart

No

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

Authorized official

Name

Miss Amy Wertenberger, LPC

Title

Clinical Director

Phone

(734) 931-6004

Specialties & licenses 2

Addresses

Other names 1

• Complete Ketamine & Wellness Doing business as

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

{
    "created_epoch": "1580169600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1580169600000",
    "number": "1215568340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "98 WINCHESTER ST",
            "city": "MONROE",
            "state": "MI",
            "postal_code": "481611957",
            "telephone_number": "734-731-9500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "98 WINCHESTER ST",
            "city": "MONROE",
            "state": "MI",
            "postal_code": "481611957",
            "telephone_number": "734-731-9500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMPLETE KETAMINE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-01-28",
        "last_updated": "2020-01-28",
        "certification_date": "2020-01-28",
        "status": "A",
        "authorized_official_last_name": "WERTENBERGER",
        "authorized_official_first_name": "AMY",
        "authorized_official_title_or_position": "CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "734-931-6004",
        "authorized_official_name_prefix": "Miss",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "367500000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Complete Ketamine & Wellness",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Mental Health Counselor in Monroe, MI
• Providers in Monroe, MI by specialty
• Mental Health Counselor in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 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.