Mighty Oak Therapy Services PLLC

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

Legal business name

MIGHTY OAK THERAPY SERVICES PLLC

Practice address

672 Lakewood Rd
Traverse City, MI 49685-8872

Phone

(231) 392-6420

Fax

(231) 346-5986

NPI assigned

Jan 27, 2021

Last updated

Jan 27, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jodi Lee Carroll, MS, OTR/LNPI 1417249798

Title

Owner

Phone

(231) 392-6420

Specialties & licenses 1

Addresses

Electronic endpoints 1

Practitioners 1

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.

• Jodi Lee Carroll, MS OTR/L

  • Occupational Therapist
  • Chicago, IL
  • NPI 1417249798
  Authorized official Same address or phone

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

{
    "created_epoch": "1611705600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1611705600000",
    "number": "1578154167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "672 LAKEWOOD RD",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496858872",
            "telephone_number": "231-392-6420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "672 LAKEWOOD RD",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496858872",
            "telephone_number": "231-392-6420",
            "fax_number": "231-346-5986"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIGHTY OAK THERAPY SERVICES PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-01-27",
        "last_updated": "2021-01-27",
        "certification_date": "2021-01-27",
        "status": "A",
        "authorized_official_last_name": "CARROLL",
        "authorized_official_first_name": "JODI",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "231-392-6420",
        "authorized_official_credential": "MS, OTR/L"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "takerootforlife@gmail.com",
            "affiliation": "N",
            "address_1": "672 Lakewood Rd",
            "city": "Traverse City",
            "state": "MI",
            "country_code": "US",
            "postal_code": "496858872",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Gerald Micketti, LLPC
• Middle Path Counseling, PLLC
• Gina R Middlebrook, FNP
• Midstream Counseling PLC
• Derek Walter Migazzi
• Brittany Mikolowski
• Sharon Mikowski
• Mark A Mikula, M.D.
• Curt M Mikulski, M.D.
• Jasmine Miles

• Occupational Therapist in Traverse City, MI
• Providers in Traverse City, MI by specialty
• Occupational Therapist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2021; 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.