NPIMap

Organization Active NPI

Wow Therapy

  • Mental Health Counselor
  • Port Huron, MI
National Provider Identifier
1386133809
Registry record updated May 10, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
6401016563 Issued in MI
Legal business name
WOW THERAPY
Practice address
805 Superior St Ste a
Port Huron, MI 48060-3771
Phone
(810) 300-6614
NPI assigned
May 10, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 10, 2018

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

Authorized official

Name
Yuvone Marie Rogers, LLPC
Title
Owner
Phone
(810) 300-6614

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YM0800X 6401016563 MI Primary

Addresses

Primary practice location

805 Superior St Ste a
Port Huron, MI 48060-3771

Mailing address

4043 Violet Ave
Saint Clair, MI 48079-3532
Phone (810) 300-6614

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1525910400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1525910400000",
    "number": "1386133809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4043 VIOLET AVE",
            "city": "SAINT CLAIR",
            "state": "MI",
            "postal_code": "480793532",
            "telephone_number": "810-300-6614"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "805 SUPERIOR ST STE A",
            "city": "PORT HURON",
            "state": "MI",
            "postal_code": "480603771",
            "telephone_number": "810-300-6614"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WOW THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-05-10",
        "last_updated": "2018-05-10",
        "status": "A",
        "authorized_official_last_name": "ROGERS",
        "authorized_official_first_name": "YUVONE",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "810-300-6614",
        "authorized_official_credential": "LLPC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": "MI",
            "license": "6401016563",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Huron, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 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.