NPIMap

Organization Active NPI

Imagine Center LLC

  • Clinical Psychologist
  • Northville, MI
National Provider Identifier
1467899666
Registry record updated May 29, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
6301013057 Issued in MI
Legal business name
IMAGINE CENTER LLC
Practice address
100 Maincentre
Ste. 16
Northville, MI 48167-1578
Phone
(313) 354-3920
Fax
(313) 656-4052
NPI assigned
May 29, 2013
Last updated
May 29, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 29, 2013

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

Authorized official

Name
Michael Edward Behen, PHDNPI 1760407696
Title
Clinical Psychologist/Director
Phone
(313) 354-3920

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 6301013057 MI Primary

Addresses

Primary practice location

100 Maincentre
Ste. 16
Northville, MI 48167-1578

Mailing address

100 Maincentre
Ste. 16
Northville, MI 48167-1578
Phone (313) 354-3920

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20151215001703 MI Part B Supplier - Clinic/Group Practice 6507167624 Receives reassigned benefits from 1 practitioner
Practice locations: Detroit, MI; Livonia, MI; Sterling Heights, MI

National Provider Directory

National Provider Directory

Locations

4160 Woodward Ave
Fl 2
Detroit, MI 48201
Phone (313) 264-3781

100 Maincentre
Ste 16
Northville, MI 48167
Phone (313) 354-3920

194 E Main St
Northville, MI 48167
Phone (248) 719-7671

42140 Van Dyke Ave
Ste 190
Sterling Heights, MI 48314

Practitioners & affiliated clinicians

Practitioners 24

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.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1369785600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1369785600000",
    "number": "1467899666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 MAINCENTRE",
            "address_2": "STE. 16",
            "city": "NORTHVILLE",
            "state": "MI",
            "postal_code": "481671578",
            "telephone_number": "313-354-3920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 MAINCENTRE",
            "address_2": "STE. 16",
            "city": "NORTHVILLE",
            "state": "MI",
            "postal_code": "481671578",
            "telephone_number": "313-354-3920",
            "fax_number": "313-656-4052"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IMAGINE CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-05-29",
        "last_updated": "2013-05-29",
        "status": "A",
        "authorized_official_last_name": "BEHEN",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "EDWARD",
        "authorized_official_title_or_position": "CLINICAL PSYCHOLOGIST/DIRECTOR",
        "authorized_official_telephone_number": "313-354-3920",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6301013057",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Northville, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2013; 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.