NPIMap

Organization Active NPI

Rochester Evidence-Based Psychotherapy Clinic, PLLC

  • Professional Counselor
  • Rochester, MI
National Provider Identifier
1326580432
Registry record updated Jun 22, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
6401011306 Issued in MI
Legal business name
ROCHESTER EVIDENCE-BASED PSYCHOTHERAPY CLINIC, PLLC
Practice address
414 S Main St
Suite 201
Rochester, MI 48307
Phone
(248) 568-5180
Fax
(248) 429-2132
NPI assigned
Nov 7, 2016
Last updated
Jun 22, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2018

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

Authorized official

Name
Mr. Adam G. Hamilton, MA, LPC, LLMFT, NCCNPI 1417247768
Title
Owner
Phone
(248) 568-5180

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YP2500X 6401011306 MI Primary
Marriage & Family TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 106H00000X 4101006671 MI

Addresses

Primary practice location

414 S Main St
Suite 201
Rochester, MI 48307

Mailing address

414 S Main St
Suite 201
Rochester, MI 48307-2068
Phone (248) 568-5180

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20181008000217 MI Part B Supplier - Clinic/Group Practice 5496007254 Receives reassigned benefits from 8 practitioners
Practice locations: Rochester Hills, MI

National Provider Directory

National Provider Directory

Locations

414 S Main St
Ste 201
Rochester, MI 48307
Phone (248) 413-5817

Practitioners & affiliated clinicians

Practitioners 12

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.

NPI Registry JSON

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

{
    "created_epoch": "1478476800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529625600000",
    "number": "1326580432",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "414 S MAIN ST",
            "address_2": "SUITE 201",
            "city": "ROCHESTER",
            "state": "MI",
            "postal_code": "483072068",
            "telephone_number": "248-568-5180",
            "fax_number": "248-429-2132"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "414 S MAIN ST",
            "address_2": "SUITE 201",
            "city": "ROCHESTER",
            "state": "MI",
            "postal_code": "48307",
            "telephone_number": "248-568-5180",
            "fax_number": "248-429-2132"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROCHESTER EVIDENCE-BASED PSYCHOTHERAPY CLINIC, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-11-07",
        "last_updated": "2018-06-22",
        "status": "A",
        "authorized_official_last_name": "HAMILTON",
        "authorized_official_first_name": "ADAM",
        "authorized_official_middle_name": "G.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "248-568-5180",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MA, LPC, LLMFT, NCC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "state": "MI",
            "license": "6401011306",
            "primary": true
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Marriage & Family Therapist",
            "state": "MI",
            "license": "4101006671",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2018; 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.