Emerging Whole Therapy LLC

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

License

6801100021 Issued in MI

Legal business name

EMERGING WHOLE THERAPY LLC

Practice address

820 W Front St
Traverse City, MI 49684-2466

Phone

(231) 715-1710

NPI assigned

Mar 7, 2018

Organization subpart

No

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

Authorized official

Name

Jennifer Superson

Title

Clinical LMSW

Phone

(231) 715-1710

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1520380800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1522022400000",
    "number": "1396247235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9283 S NOVAK RD",
            "city": "CEDAR",
            "state": "MI",
            "postal_code": "496219792",
            "telephone_number": "231-715-1710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "820 W FRONT ST",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496842466",
            "telephone_number": "231-715-1710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EMERGING WHOLE THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-03-07",
        "last_updated": "2018-03-26",
        "status": "A",
        "authorized_official_last_name": "SUPERSON",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "CLINICAL LMSW",
        "authorized_official_telephone_number": "231-715-1710"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "MI",
            "license": "6801100021",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alexandra Ellis
• Charlotte Lynn Ellis, PA
• Stephanie Ellis
• Katherine Renee Elms, M.D.
• Elmwood Charter Township
• Jordyn Emery, DO
• Emily S. Kohler, LMSW PLLC
• Energize Wellness & Physical Therapy, PLLC
• Engel Mind Body Psychiatry PLLC
• Michael Engel, DO

• Mental Health Clinic/Center (Including Community Mental Health Center) in Traverse City, MI
• Providers in Traverse City, MI by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 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.