Michigan Safe Space LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

MICHIGAN SAFE SPACE LLC

Practice address

151 N Shore Dr W
Cadillac, MI 49601-8208

Phone

(734) 301-7668

Fax

(734) 667-3925

NPI assigned

Oct 11, 2022

Organization subpart

No

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

Authorized official

Name

Chad Allee, LMSWNPI 1457750440

Title

Owner

Phone

(734) 845-6015

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Practitioners 4

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

• Chad Allee, LMSW

  • Clinical Social Worker
  • Plymouth, MI
  • NPI 1457750440
  Medicare reassignment Care Compare group NPD Authorized official
• Tyler Lee Blackstock, LLPC. CADC

  • Professional Counselor
  • Plymouth, MI
  • NPI 1801439112
  Medicare reassignment Care Compare group NPD
• Matthew Gooder

  • Clinical Social Worker
  • Plymouth, MI
  • NPI 1790434751
  Medicare reassignment NPD
• Abbie Marie Walters, MSW

  • Clinical Social Worker
  • Plymouth, MI
  • NPI 1780433177
  NPD

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

{
    "created_epoch": "1665446400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1710720000000",
    "number": "1407571581",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1044",
            "city": "CADILLAC",
            "state": "MI",
            "postal_code": "496016044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "151 N SHORE DR W",
            "city": "CADILLAC",
            "state": "MI",
            "postal_code": "496018208",
            "telephone_number": "734-301-7668",
            "fax_number": "734-667-3925"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHIGAN SAFE SPACE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-10-11",
        "last_updated": "2024-03-18",
        "certification_date": "2024-03-18",
        "status": "A",
        "authorized_official_last_name": "ALLEE",
        "authorized_official_first_name": "CHAD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "734-845-6015",
        "authorized_official_credential": "LMSW"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mercy Surgical Care
• Marcella Marie Metzger, RPH
• Mi Independent Living LLC
• Michigan Hearing Systems
• Michigan Imassage
• Michigan Therapy and Counseling LLC
• Marjorie Middel, M.S. W
• Midwest Michigan Psychological Associates, PLLC
• Vanessa Mihalick, RD
• Milinda'S Counseling Services, LLC

• Clinical Social Worker in Cadillac, MI
• Providers in Cadillac, 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 Mar 18, 2024; 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.