NPIMap

Organization Active NPI

Eastwood Community Clinics

Doing business as Eastwood Clinics

  • Psychologist
  • Saint Clair, MI
National Provider Identifier
1285854414
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
Legal business name
EASTWOOD COMMUNITY CLINICS
Doing business as
Eastwood Clinics
Practice address
132 Trumbull St
Saint Clair, MI 48079-5372
Phone
(810) 329-5340
Fax
(810) 329-8964
NPI assigned
Apr 30, 2007
Last updated
Jul 21, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
EASTWOOD COMMUNITY CLINICSAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Steven Candela, LMSW
Title
Director
Phone
(586) 753-0400

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X NU
Psychologist 103T00000X NU Primary
Social Worker 104100000X NU
Marriage & Family Therapist 106H00000X NU
Psychiatry Physician 2084P0800X NU

Addresses

Primary practice location

132 Trumbull St
Saint Clair, MI 48079-5372

Mailing address

28000 Dequindre Rd
Warren, MI 48092-2468
Phone (586) 753-0400

Other identifiers 1

IdentifierTypeStateIssuer
20547OtherMIBCBSMI SA NUMBER

Other names 1

  • Eastwood Clinics Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Eastwood Clinics23 organizations share this tax ID, including this one
Part of
Eastwood Clinics

Other organizations with this tax ID 22

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

View all 22

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1177891200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1285854414",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28000 DEQUINDRE RD",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480922468",
            "telephone_number": "586-753-0400",
            "fax_number": "586-753-0404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "132 TRUMBULL ST",
            "city": "SAINT CLAIR",
            "state": "MI",
            "postal_code": "480795372",
            "telephone_number": "810-329-5340",
            "fax_number": "810-329-8964"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EASTWOOD COMMUNITY CLINICS",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "EASTWOOD COMMUNITY CLINICS",
        "enumeration_date": "2007-04-30",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "CANDELA",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "586-753-0400",
        "authorized_official_credential": "LMSW"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSMI SA NUMBER",
            "identifier": "20547",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Eastwood Clinics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Saint Clair, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 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.