Thera Support

Primary specialty

PsychologistTaxonomy code 103T00000X

License

6301001432 Issued in MI

Legal business name

THERA SUPPORT

Practice address

4343 Concourse Dr Ste 250
Ann Arbor, MI 48108-8672

Phone

(734) 677-0200

Fax

(734) 677-3310

NPI assigned

Sep 11, 2007

Organization subpart

No

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

Authorized official

Name

Thomas S Rosenbaum, PHDNPI 1518013986

Title

Licensed Psychologist

Phone

(734) 677-0200

Specialties & licenses 3

Addresses

Tax ID family

Thera Support2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Therasupport, LLC

  • Clinical Psychologist
  • Ann Arbor, MI
  • NPI 1295129799
  NPD tax ID

Locations

Practitioners 1

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

• Thomas S Rosenbaum, PH.D.

  • Psychologist
  • Ann Arbor, MI
  • NPI 1518013986
  NPD Authorized official

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

{
    "created_epoch": "1189468800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1670889600000",
    "number": "1235324484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4343 CONCOURSE DR STE 250",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481088672",
            "telephone_number": "734-677-0200",
            "fax_number": "734-677-3310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4343 CONCOURSE DR STE 250",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481088672",
            "telephone_number": "734-677-0200",
            "fax_number": "734-677-3310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THERA SUPPORT",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-11",
        "last_updated": "2022-12-13",
        "certification_date": "2022-12-13",
        "status": "A",
        "authorized_official_last_name": "ROSENBAUM",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "LICENSED PSYCHOLOGIST",
        "authorized_official_telephone_number": "734-677-0200",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": "MI",
            "license": "6301001432",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501012103",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": "MI",
            "license": "5201000891",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary E Theisen-Goodvich, PHD
• Jeremy Theiss, M.D.
• Lindsey Jill Theiss, LMSW
• Eby Ison Thekkedath, DO
• Lena Theodorou-Ehrlich, PSY.D.
• Therabee
• Therapeutic Pharmacy Partners LLC
• Therapy for Change PLLC
• Therasupport, LLC
• Theresa Gattari MD, PLLC

• Psychologist in Ann Arbor, MI
• Providers in Ann Arbor, MI by specialty
• Psychologist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2022; 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.