Organization Active NPI

Rose Oak Mental Health PLLC

  • Social Worker
  • Clio, MI
National Provider Identifier
1497517288
Registry record updated Mar 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
Legal business name
ROSE OAK MENTAL HEALTH PLLC
Practice address
11308 Autumn Breeze TRL Ste 1
Clio, MI 48420-1592
Phone
(989) 996-5544
NPI assigned
Jan 26, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2024

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

Authorized official

Name
Destiny Ernestine Reikowsky, LMSW
Title
Owner/Clinical Therapist
Phone
(989) 996-5544

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 104100000X Primary

Addresses

Primary practice location

11308 Autumn Breeze TRL Ste 1
Clio, MI 48420-1592

Mailing address

11308 Autumn Breeze TRL Ste 1
Clio, MI 48420-1592
Phone (989) 996-5544

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1706227200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1709769600000",
    "number": "1497517288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11308 AUTUMN BREEZE TRL STE 1",
            "city": "CLIO",
            "state": "MI",
            "postal_code": "484201592",
            "telephone_number": "989-996-5544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11308 AUTUMN BREEZE TRL STE 1",
            "city": "CLIO",
            "state": "MI",
            "postal_code": "484201592",
            "telephone_number": "989-996-5544"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROSE OAK MENTAL HEALTH PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-01-26",
        "last_updated": "2024-03-07",
        "certification_date": "2024-03-07",
        "status": "A",
        "authorized_official_last_name": "REIKOWSKY",
        "authorized_official_first_name": "DESTINY",
        "authorized_official_middle_name": "ERNESTINE",
        "authorized_official_title_or_position": "OWNER/CLINICAL THERAPIST",
        "authorized_official_telephone_number": "989-996-5544",
        "authorized_official_credential": "LMSW"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clio, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2024; 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.