New Branch Art Therapy Services LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

NEW BRANCH ART THERAPY SERVICES LLC

Practice address

14411 Kingston St
Oak Park, MI 48237-1141

Phone

(248) 217-4419

NPI assigned

Oct 15, 2024

Last updated

Oct 15, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Kathryn Elizabeth Whitlock, ATR-BC, LPC, CCTP-IINPI 1962171835

Title

Clinical Director/Ops Manager

Phone

(248) 217-4419

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, and the practitioner matching its NPPES authorized official.

• Kathryn Elizabeth Whitlock, ATR-BC, LPC, CCTP-II

  • Professional Counselor
  • Oak Park, MI
  • NPI 1962171835
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1728950400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1728950400000",
    "number": "1245050020",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14411 KINGSTON ST",
            "city": "OAK PARK",
            "state": "MI",
            "postal_code": "482371141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14411 KINGSTON ST",
            "city": "OAK PARK",
            "state": "MI",
            "postal_code": "482371141",
            "telephone_number": "248-217-4419"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW BRANCH ART THERAPY SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-10-15",
        "last_updated": "2024-10-15",
        "certification_date": "2024-10-15",
        "status": "A",
        "authorized_official_last_name": "WHITLOCK",
        "authorized_official_first_name": "KATHRYN",
        "authorized_official_middle_name": "ELIZABETH",
        "authorized_official_title_or_position": "CLINICAL DIRECTOR/OPS MANAGER",
        "authorized_official_telephone_number": "248-217-4419",
        "authorized_official_credential": "ATR-BC, LPC, CCTP-II"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Community/Behavioral Health Agency in Oak Park, MI
• Providers in Oak Park, MI by specialty
• Community/Behavioral Health Agency in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 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.