NPIMap

Organization Active NPI

Shiawassee County Community Mental Health Authority

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Owosso, MI
National Provider Identifier
1497749279
Registry record updated Jan 18, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
SHIAWASSEE COUNTY COMMUNITY MENTAL HEALTH AUTHORITY
Practice address
1555 Industrial Dr
Owosso, MI 48867-9775
Phone
(989) 723-6791
Fax
(989) 725-5061
NPI assigned
Sep 7, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2018

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

Authorized official

Name
Laura Stephen
Title
Financial Services Supervisor
Phone
(989) 723-0732

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X MI Primary

Addresses

Primary practice location

1555 Industrial Dr
Owosso, MI 48867-9775

Mailing address

1555 Industrial Dr
Owosso, MI 48867-9775
Phone (989) 723-6791

Other identifiers 5

IdentifierTypeStateIssuer
P10G81020OtherMIBCBS
0G86005OtherMIBCBS
105813OtherVALUE OPTIONS
0G86087OtherMIBCBS
774351238MedicaidMI

Other names 1

  • Shiawassee Health & Wellness Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040227000542 MI Part B Supplier - Clinic/Group Practice 6002702750 Receives reassigned benefits from 7 practitioners
Practice locations: Owosso, MI
O20040227000575 MI Part B Supplier - Clinic/Group Practice 6002702750 Receives reassigned benefits from 6 practitioners
Practice locations: Owosso, MI

National Provider Directory

National Provider Directory

Ownership & related parties

Subparts reporting this organization as parent 3

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 21

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

View all 21

NPI Registry JSON

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

{
    "created_epoch": "1126051200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1516233600000",
    "number": "1497749279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1555 INDUSTRIAL DR",
            "city": "OWOSSO",
            "state": "MI",
            "postal_code": "488679775",
            "telephone_number": "989-723-6791",
            "fax_number": "989-725-5061"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1555 INDUSTRIAL DR",
            "city": "OWOSSO",
            "state": "MI",
            "postal_code": "488679775",
            "telephone_number": "989-723-6791",
            "fax_number": "989-725-5061"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHIAWASSEE COUNTY COMMUNITY MENTAL HEALTH AUTHORITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-07",
        "last_updated": "2018-01-18",
        "status": "A",
        "authorized_official_last_name": "STEPHEN",
        "authorized_official_first_name": "LAURA",
        "authorized_official_title_or_position": "FINANCIAL SERVICES SUPERVISOR",
        "authorized_official_telephone_number": "989-723-0732"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "MI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "P10G81020",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0G86005",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUE OPTIONS",
            "identifier": "105813",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0G86087",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "774351238",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Shiawassee Health & Wellness",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Owosso, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2018; 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.