Third Coast Center for Emotional Wellness PLLC

Primary specialty

Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X

License

6401015285 Issued in MI

Legal business name

THIRD COAST CENTER FOR EMOTIONAL WELLNESS PLLC

Doing business as

Third Coast Counseling

Practice address

733 E 8TH St Ste 204
Traverse City, MI 49686-2665

Phone

(231) 753-3134

NPI assigned

May 4, 2018

Last updated

May 4, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jakob Rossi, LPCNPI 1467809723

Title

Owner

Phone

(231) 632-0814

Specialties & licenses 1

Addresses

Other names 1

• Third Coast Counseling Doing business as

Locations

Practitioners 1

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.

• Jakob Rossi, LPC

  • Professional Counselor
  • Traverse City, MI
  • NPI 1467809723
  NPD (past) Authorized official

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

{
    "created_epoch": "1525392000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1525392000000",
    "number": "1366931453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1601 E 8TH ST",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496862923",
            "telephone_number": "231-632-0814"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "733 E 8TH ST STE 204",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496862665",
            "telephone_number": "231-753-3134"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THIRD COAST CENTER FOR EMOTIONAL WELLNESS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-05-04",
        "last_updated": "2018-05-04",
        "status": "A",
        "authorized_official_last_name": "ROSSI",
        "authorized_official_first_name": "JAKOB",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "231-632-0814",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "MI",
            "license": "6401015285",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Third Coast Counseling",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Third Coast Counseling",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Adult Mental Health Clinic/Center in Traverse City, MI
• Providers in Traverse City, MI by specialty
• Adult Mental Health Clinic/Center in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2018; 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.