Organization Active NPI

Withstand Emotional Health Recovery

  • Clinical Social Worker
  • Detroit, MI
National Provider Identifier
1346024973
Registry record updated Nov 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
WITHSTAND EMOTIONAL HEALTH RECOVERY
Practice address
17620 Shaftsbury Ave
Detroit, MI 48219-3593
Phone
(248) 667-8047
NPI assigned
Aug 23, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 24, 2023

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

Authorized official

Name
Truvella Porter, LMSWNPI 1346720406
Title
Ceo
Phone
(248) 667-8047

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X Primary
Adult Mental Health Clinic/Center 261QM0850X
Adolescent and Children Mental Health Clinic/Center 261QM0855X

Addresses

Primary practice location

17620 Shaftsbury Ave
Detroit, MI 48219-3593

Mailing address

3512 Macnichol TRL
West Bloomfield, MI 48323-1734
Phone (248) 667-8047

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20231228002123 MI Part B Supplier - Clinic/Group Practice 0143670406 Receives reassigned benefits from 1 practitioner
Practice locations: Detroit, MI

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1692748800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1700784000000",
    "number": "1346024973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3512 MACNICHOL TRL",
            "city": "WEST BLOOMFIELD",
            "state": "MI",
            "postal_code": "483231734",
            "telephone_number": "248-667-8047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17620 SHAFTSBURY AVE",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482193593",
            "telephone_number": "248-667-8047"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WITHSTAND EMOTIONAL HEALTH RECOVERY",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-08-23",
        "last_updated": "2023-11-24",
        "certification_date": "2023-11-24",
        "status": "A",
        "authorized_official_last_name": "PORTER",
        "authorized_official_first_name": "TRUVELLA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "248-667-8047",
        "authorized_official_credential": "LMSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2023; 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.