Advanced Mental Health and Tbi Services PLLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

ADVANCED MENTAL HEALTH AND TBI SERVICES PLLC

Practice address

9864 E Grand River Ave Ste 110-131
Brighton, MI 48116-1963

Phone

(810) 844-6146

Fax

(248) 282-7022

NPI assigned

Feb 24, 2022

Organization subpart

Yes

Parent organization

ADVANCED MENTAL HEALTH AND TBI SERVICES PLLCAs reported in NPPES

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

Authorized official

Name

Donald Booth, LMSW

Title

Owner

Phone

(810) 844-6146

Specialties & licenses 1

Addresses

Part of

Advanced Mental Health and Tbi Services PLLC

Locations

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

{
    "created_epoch": "1645660800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1645660800000",
    "number": "1255087698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1384 SEWARD CT",
            "city": "BRIGHTON",
            "state": "MI",
            "postal_code": "481163790",
            "telephone_number": "810-844-6146",
            "fax_number": "248-282-7022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9864 E GRAND RIVER AVE STE 110-131",
            "city": "BRIGHTON",
            "state": "MI",
            "postal_code": "481161963",
            "telephone_number": "810-844-6146",
            "fax_number": "248-282-7022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED MENTAL HEALTH AND TBI SERVICES PLLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ADVANCED MENTAL HEALTH AND TBI SERVICES PLLC",
        "enumeration_date": "2022-02-24",
        "last_updated": "2022-02-24",
        "certification_date": "2022-01-25",
        "status": "A",
        "authorized_official_last_name": "BOOTH",
        "authorized_official_first_name": "DONALD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "810-844-6146",
        "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": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 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.