NPIMap

Organization Active NPI

Mini Mitten Pediatric Therapy, LLC

  • Occupational Therapist
  • Monroe, MI
National Provider Identifier
1528655826
Registry record updated Jun 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
Legal business name
MINI MITTEN PEDIATRIC THERAPY, LLC
Practice address
7447 N Telegraph Rd
Monroe, MI 48162-9328
Phone
(734) 888-6464
Fax
(734) 275-0985
NPI assigned
Dec 21, 2020
Last updated
Jun 5, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2025

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

Authorized official

Name
Casey Bross, OTD, OTRL, CLT, CLC
Title
Owner
Phone
(734) 888-6464

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X NU
Occupational Therapist 225X00000X NU Primary
Speech-Language Pathologist 235Z00000X NU
Adolescent and Children Mental Health Clinic/Center 261QM0855X NU
Multi-Specialty Clinic/Center 261QM1300X NU
Rehabilitation Clinic/Center 261QR0400X NU

Addresses

Primary practice location

7447 N Telegraph Rd
Monroe, MI 48162-9328

Mailing address

7447 N Telegraph Rd
Monroe, MI 48162-9328
Phone (734) 888-6464

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210323000530 MI Part B Supplier - Physical/Occupational Therapy Group in Private Practice 7113334996 Receives reassigned benefits from 8 practitioners
Practice locations: Monroe, MI

National Provider Directory

National Provider Directory

Locations

7447 N Telegraph Rd
Monroe, MI 48162
Phone (734) 888-6464

7447 N Telegraph Rd
#M
Monroe, MI 48162
Phone (734) 888-6464

Practitioners & affiliated clinicians

Practitioners 13

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 13

NPI Registry JSON

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

{
    "created_epoch": "1608508800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1749081600000",
    "number": "1528655826",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7447 N TELEGRAPH RD",
            "city": "MONROE",
            "state": "MI",
            "postal_code": "481629328",
            "telephone_number": "734-888-6464",
            "fax_number": "734-275-0985"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7447 N TELEGRAPH RD",
            "city": "MONROE",
            "state": "MI",
            "postal_code": "481629328",
            "telephone_number": "734-888-6464",
            "fax_number": "734-275-0985"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINI MITTEN PEDIATRIC THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-12-21",
        "last_updated": "2025-06-05",
        "certification_date": "2025-06-05",
        "status": "A",
        "authorized_official_last_name": "BROSS",
        "authorized_official_first_name": "CASEY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "734-888-6464",
        "authorized_official_credential": "OTD, OTRL, CLT, CLC"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Monroe, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2025; 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.