NPIMap

Organization Active NPI

Lifeline Center, PLLC

  • Community/Behavioral Health Agency
  • Clinton Township, MI
National Provider Identifier
1316351992
Registry record updated Jan 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
6801096616 Issued in MI
Legal business name
LIFELINE CENTER, PLLC
Practice address
41800 Hayes Rd
Suite 208
Clinton Township, MI 48038-1876
Phone
(888) 910-9922
NPI assigned
Jun 11, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2021

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

Authorized official

Name
Mrs. Sherita Harvey, LMSWNPI 1104248426
Title
Clinical Social Worker
Phone
(586) 343-2154

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 104100000X
Case Management Agency 251B00000X 6801096616 MI
Home Health Agency 251E00000X 6801096616 MI
Public Health or Welfare Agency 251K00000X 6801096616 MI
Community/Behavioral Health Agency 251S00000X 6801096616 MI Primary

Addresses

Primary practice location

41800 Hayes Rd
Suite 208
Clinton Township, MI 48038-1876

Mailing address

PO Box 216
Washington, MI 48094-0216
Phone (888) 910-9922

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150128001453 MI Part B Supplier - Clinic/Group Practice 1658695390 Receives reassigned benefits from 2 practitioners
Practice locations: Clinton Township, MI; Hazel Park, MI

National Provider Directory

National Provider Directory

Locations

41800 Hayes Rd
Ste 208
Clinton Twp, MI 48038
Phone (586) 203-2170

Practitioners & affiliated clinicians

Practitioners 8

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

NPI Registry JSON

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

{
    "created_epoch": "1402444800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1609718400000",
    "number": "1316351992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 216",
            "city": "WASHINGTON",
            "state": "MI",
            "postal_code": "480940216",
            "telephone_number": "888-910-9922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "41800 HAYES RD",
            "address_2": "SUITE 208",
            "city": "CLINTON TOWNSHIP",
            "state": "MI",
            "postal_code": "480381876",
            "telephone_number": "888-910-9922"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFELINE CENTER, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-06-11",
        "last_updated": "2021-01-04",
        "certification_date": "2021-01-04",
        "status": "A",
        "authorized_official_last_name": "HARVEY",
        "authorized_official_first_name": "SHERITA",
        "authorized_official_title_or_position": "CLINICAL SOCIAL WORKER",
        "authorized_official_telephone_number": "586-343-2154",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LMSW"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "MI",
            "license": "6801096616",
            "primary": false
        },
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "MI",
            "license": "6801096616",
            "primary": false
        },
        {
            "code": "251K00000X",
            "taxonomy_group": "",
            "desc": "Public Health or Welfare",
            "state": "MI",
            "license": "6801096616",
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "MI",
            "license": "6801096616",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clinton Township, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2021; 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.