Your Path Therapy Group, PLLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

YOUR PATH THERAPY GROUP, PLLC

Practice address

44444 Hayes Rd
Clinton Township, MI 48038-7600

Phone

(586) 210-6682

NPI assigned

Mar 13, 2024

Organization subpart

No

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

Authorized official

Name

Mr. Gage L Peavler, LMSWNPI 1922691120

Title

President

Phone

(586) 770-1202

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Practitioners 1

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

• Gage Peavler, LMSW

  • Clinical Social Worker
  • Clinton Township, MI
  • NPI 1922691120
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1710288000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1710288000000",
    "number": "1215795224",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17693 MAISONS DR",
            "city": "CLINTON TOWNSHIP",
            "state": "MI",
            "postal_code": "480383802",
            "telephone_number": "586-322-5905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44444 HAYES RD",
            "city": "CLINTON TOWNSHIP",
            "state": "MI",
            "postal_code": "480387600",
            "telephone_number": "586-210-6682"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YOUR PATH THERAPY GROUP, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-03-13",
        "last_updated": "2024-03-13",
        "certification_date": "2024-03-13",
        "status": "A",
        "authorized_official_last_name": "PEAVLER",
        "authorized_official_first_name": "GAGE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "586-770-1202",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LMSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Georgia Jauhar Youhanan
• Betty Young, BA
• Carl Stacy Young, MA, MS ED, LLPC
• Donald Alan Young
• Sura Young
• James Martin Yuhnke, D.D.S.
• Kelly Lyn Yurgo, B.S.R.S.S.T
• Chelsey Donn Yurkovich, D.O.
• Allyse Zabolotny
• Ann Veronica Zaccagnini, DO

• Clinical Social Worker in Clinton Township, MI
• Providers in Clinton Township, MI by specialty
• Clinical Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.