Child and Young Adult Resource Center

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

CHILD AND YOUNG ADULT RESOURCE CENTER

Doing business as

PHYLLIS GRUBER CHILD AND YOUNG ADULT RESOURCE CENTER

Practice address

3804 Hazel Ave
Lincoln Park, MI 48146-3739

Phone

(734) 552-8539

NPI assigned

Nov 2, 2023

Organization subpart

No

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

Authorized official

Name

Fred H Gruber

Title

Owner

Phone

(734) 552-8539

Specialties & licenses 1

Addresses

Other names 1

• PHYLLIS GRUBER CHILD AND YOUNG ADULT RESOURCE CENTER Doing business as

Locations

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

{
    "created_epoch": "1698883200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1698883200000",
    "number": "1508639444",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3804 HAZEL AVE",
            "city": "LINCOLN PARK",
            "state": "MI",
            "postal_code": "481463739",
            "telephone_number": "734-552-8539"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3804 HAZEL AVE",
            "city": "LINCOLN PARK",
            "state": "MI",
            "postal_code": "481463739",
            "telephone_number": "734-552-8539"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHILD AND YOUNG ADULT RESOURCE CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-11-02",
        "last_updated": "2023-11-02",
        "certification_date": "2023-11-02",
        "status": "A",
        "authorized_official_last_name": "GRUBER",
        "authorized_official_first_name": "FRED",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "734-552-8539"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PHYLLIS GRUBER CHILD AND YOUNG ADULT RESOURCE CENTER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Carolyn'S Home Healthcare Services, LLC
• Dachelle Carter, MSW
• Sherron Chandler
• Charles M. Gilcher D.C., P.C.
• Robert Louis Cheetham, LMSW
• Abdul Chudhry
• City of Lincoln Park / Lincoln Park Fire Department
• Stephanie Elaine Clay
• Julia Tiana Clogston, LLMSW
• Justin Coates

• Mental Health Counselor in Lincoln Park, MI
• Providers in Lincoln Park, MI by specialty
• Mental Health Counselor in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2023; 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.