Organization Active NPI

Allcare Mental Wellness LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Southfield, MI
National Provider Identifier
1558216630
Registry record updated Jul 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
ALLCARE MENTAL WELLNESS LLC
Practice address
24225 W 9 Mile Rd Ste 170
Southfield, MI 48033-3978
Phone
(248) 796-7466
Fax
(336) 654-0824
NPI assigned
Mar 3, 2026
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2026

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

Authorized official

Name
Tiffany Shandrea JohnsonNPI 1730572660
Title
Provider
Phone
(313) 731-2719

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 4

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X
Home Health Agency 251E00000X
Family Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X
Psychiatric/Mental Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LP0808X Primary

Addresses

Primary practice location

24225 W 9 Mile Rd Ste 170
Southfield, MI 48033-3978

Mailing address

24225 W 9 Mile Rd Ste 170
Southfield, MI 48033-3978
Phone (248) 796-7466

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20260422001081 MI Part B Supplier - Clinic/Group Practice 4688141112 Receives reassigned benefits from 2 practitioners
Practice locations: Southfield, MI

National Provider Directory

National Provider Directory

Locations

24225 W 9 Mile Rd
Ste 170
Southfield, MI 48033

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1772496000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1784246400000",
    "number": "1558216630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24225 W 9 MILE RD STE 170",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480333978",
            "telephone_number": "248-796-7466",
            "fax_number": "336-654-0824"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24225 W 9 MILE RD STE 170",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480333978",
            "telephone_number": "248-796-7466",
            "fax_number": "336-654-0824"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALLCARE MENTAL WELLNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-03-03",
        "last_updated": "2026-07-17",
        "certification_date": "2026-07-17",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "TIFFANY",
        "authorized_official_middle_name": "SHANDREA",
        "authorized_official_title_or_position": "PROVIDER",
        "authorized_official_telephone_number": "313-731-2719"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southfield, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2026; 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.