NPIMap

Organization Active NPI

Great Lakes Clinical Care Services LLC

  • Community/Behavioral Health Agency
  • Southfield, MI
National Provider Identifier
1437522596
Registry record updated Nov 10, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
6801087398 Issued in MI
Legal business name
GREAT LAKES CLINICAL CARE SERVICES LLC
Practice address
22350 Lucerne Dr
Apt 201
Southfield, MI 48075-5953
Phone
(248) 443-5613
NPI assigned
Nov 10, 2015
Last updated
Nov 10, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2015

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

Authorized official

Name
Ms. Cynthia Baxter, LMSWNPI 1598149437
Title
Clinical Supervisor
Phone
(248) 443-5613

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X 6801087398 MI Primary

Addresses

Primary practice location

22350 Lucerne Dr
Apt 201
Southfield, MI 48075-5953

Mailing address

22350 Lucerne Dr
Apt 201
Southfield, MI 48075-5953
Phone (248) 443-5613

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1447113600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1447113600000",
    "number": "1437522596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22350 LUCERNE DR",
            "address_2": "APT 201",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480755953",
            "telephone_number": "248-443-5613"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22350 LUCERNE DR",
            "address_2": "APT 201",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480755953",
            "telephone_number": "248-443-5613"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREAT LAKES CLINICAL CARE SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-11-10",
        "last_updated": "2015-11-10",
        "status": "A",
        "authorized_official_last_name": "BAXTER",
        "authorized_official_first_name": "CYNTHIA",
        "authorized_official_title_or_position": "CLINICAL SUPERVISOR",
        "authorized_official_telephone_number": "248-443-5613",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LMSW"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "MI",
            "license": "6801087398",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southfield, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2015; 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.