Dawn Renee Terez Hillstrom

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

640101875 Issued in MI

Practice address

50258 Van Dyke Ave Ste a
Shelby Township, MI 48317-1374

Phone

(586) 884-4714

Fax

(586) 884-4693

NPI assigned

Oct 29, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Dawn Renee Terez Fowler Former name

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

The Route to Wellness LLCGroup PAC ID 1254797012, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• The Route to Wellness, LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Royal Oak, MI
  • NPI 1144921131
  Medicare reassignment Care Compare group NPD
• Kindmind Psychiatric Health

  • Psychiatry Physician
  • Clarkston, MI
  • NPI 1093409666
  NPD (past)

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

{
    "created_epoch": "1603929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603929600000",
    "number": "1407456262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50258 VAN DYKE AVE STE A",
            "city": "SHELBY TOWNSHIP",
            "state": "MI",
            "postal_code": "483171374",
            "telephone_number": "586-884-4714",
            "fax_number": "586-884-4693"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50258 VAN DYKE AVE STE A",
            "city": "SHELBY TOWNSHIP",
            "state": "MI",
            "postal_code": "483171374",
            "telephone_number": "586-884-4714",
            "fax_number": "586-884-4693"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HILLSTROM",
        "first_name": "DAWN",
        "middle_name": "RENEE TEREZ",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-10-29",
        "last_updated": "2020-10-29",
        "certification_date": "2020-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MI",
            "license": "640101875",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MI",
            "license": "6401018750",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6401018750",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DAWN",
            "last_name": "FOWLER",
            "middle_name": "RENEE TEREZ",
            "credential": "LLPC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Carly Karen Hickey, COTA
• Shaun Patrick Hickey, COTA
• Hannah Hicks
• Brooklynn Hihnala
• Joseph M Hildebrand, DDS
• Liza Hinchey, PHD, LP, LPC
• Christina Mary Hing, C.O.T.A.
• HNW Physical Therapy, Inc
• Huy Ho
• Marjorie Kay Hockenberry, OTR

• Mental Health Counselor in Shelby Township, MI
• Providers in Shelby Township, MI by specialty
• Mental Health Counselor in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.