Your Space Therapy, PLLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

YOUR SPACE THERAPY, PLLC

Practice address

411 Monroe St
Petoskey, MI 49770-2234

Phone

(231) 753-6462

NPI assigned

Jan 26, 2023

Organization subpart

No

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

Authorized official

Name

Amber L Merrow, LMSWNPI 1578979142

Title

Owner

Phone

(810) 210-0953

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Practitioners 1

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

• Amber Merrow, MSW, LMSW

  • Clinical Social Worker
  • Petoskey, MI
  • NPI 1578979142
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1674691200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1675468800000",
    "number": "1356057939",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "411 MONROE ST",
            "city": "PETOSKEY",
            "state": "MI",
            "postal_code": "497702234",
            "telephone_number": "231-753-6462"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 MONROE ST",
            "city": "PETOSKEY",
            "state": "MI",
            "postal_code": "497702234",
            "telephone_number": "231-753-6462"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YOUR SPACE THERAPY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-01-26",
        "last_updated": "2023-02-04",
        "certification_date": "2023-02-04",
        "status": "A",
        "authorized_official_last_name": "MERROW",
        "authorized_official_first_name": "AMBER",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "810-210-0953",
        "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": []
}

• Alfred Joseph Wroblewski Jr., M.D.
• WSSH Powerback Rehabilitation Services, LLC
• Casper T Wurtsmith, MA, LPC, CAADC
• Tamara Lee Wyman, M.A., CCC-SLP
• Sunyoung You
• Pedro Zamora, M.D.
• Jason B Zielinski, ABOC/NCLEC

• Clinical Social Worker in Petoskey, MI
• Providers in Petoskey, MI by specialty
• Clinical Social Worker in Michigan

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