Extraordinary Minds Therapy Practice, PLLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

EXTRAORDINARY MINDS THERAPY PRACTICE, PLLC

Practice address

21 Kercheval Ave Ste 370
Grosse Pointe Farms, MI 48236-3647

Phone

(313) 969-0196

NPI assigned

Dec 10, 2024

Organization subpart

No

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

Authorized official

Name

Mrs. Arianna M Zimmerman, LMSW, CSTNPI 1356987838

Title

Clinical Psychotherapist

Phone

(313) 969-0196

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Arianna Maria Zimmerman

  • Clinical Social Worker
  • Grosse Pointe Farms, MI
  • NPI 1356987838
  NPD Authorized official

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

{
    "created_epoch": "1733788800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1733788800000",
    "number": "1568278992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 KERCHEVAL AVE STE 370",
            "city": "GROSSE POINTE FARMS",
            "state": "MI",
            "postal_code": "482363647",
            "telephone_number": "313-969-0196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 KERCHEVAL AVE STE 370",
            "city": "GROSSE POINTE FARMS",
            "state": "MI",
            "postal_code": "482363647",
            "telephone_number": "313-969-0196"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXTRAORDINARY MINDS THERAPY PRACTICE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-12-10",
        "last_updated": "2024-12-10",
        "certification_date": "2024-12-10",
        "status": "A",
        "authorized_official_last_name": "ZIMMERMAN",
        "authorized_official_first_name": "ARIANNA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CLINICAL PSYCHOTHERAPIST",
        "authorized_official_telephone_number": "313-969-0196",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LMSW, CST"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hayley Dymond
• Eastside Counseling and Consulting, Inc.
• Ciara L Eatmon, NP
• Raleigh D Eckert, PA, MSPH
• Debra E Evola, P.A.-C.
• Maha Fakherddine, MD
• Ashley Nicole Falco, M.D.
• Victoria Kathleen Helen Fawaz, NP
• Travis Michael Fields, PT, DPT
• Leo Fisher

• Clinical Social Worker in Grosse Pointe Farms, MI
• Providers in Grosse Pointe Farms, MI by specialty
• Clinical Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 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.