NPIMap

Organization Active NPI

Stepping Stones Wellness Center, PLLC

  • Clinical Psychologist
  • Plymouth, MI
National Provider Identifier
1598038234
Registry record updated Sep 19, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
6301014556 Issued in MI
Legal business name
STEPPING STONES WELLNESS CENTER, PLLC
Practice address
595 Forest Ave
Suite 7a
Plymouth, MI 48170-1775
Phone
(734) 446-5466
Fax
(734) 446-2716
NPI assigned
Feb 10, 2012
Last updated
Sep 19, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2016

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

Authorized official

Name
Dr. Denise L Brooks, PSYDNPI 1285961532
Title
Clinical Psychologist
Phone
(734) 446-5466

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X 6301014556 MI Primary

Addresses

Primary practice location

595 Forest Ave
Suite 7a
Plymouth, MI 48170-1775

Mailing address

595 Forest Ave
Suite 7a
Plymouth, MI 48170-1775
Phone (734) 446-5466

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160926000098 MI Part B Supplier - Clinic/Group Practice 3577850122 Receives reassigned benefits from 5 practitioners
Practice locations: Plymouth, MI

National Provider Directory

National Provider Directory

Locations

595 Forest Ave
Plymouth, MI 48170
Phone (734) 446-5466

595 Forest Ave
Ste 7A
Plymouth, MI 48170
Phone (734) 446-5466

Practitioners & affiliated clinicians

Practitioners 14

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 14

NPI Registry JSON

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

{
    "created_epoch": "1328832000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1474243200000",
    "number": "1598038234",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "595 FOREST AVE",
            "address_2": "SUITE 7A",
            "city": "PLYMOUTH",
            "state": "MI",
            "postal_code": "481701775",
            "telephone_number": "734-446-5466",
            "fax_number": "734-446-2716"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "595 FOREST AVE",
            "address_2": "SUITE 7A",
            "city": "PLYMOUTH",
            "state": "MI",
            "postal_code": "481701775",
            "telephone_number": "734-446-5466",
            "fax_number": "734-446-2716"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STEPPING STONES WELLNESS CENTER, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-02-10",
        "last_updated": "2016-09-19",
        "status": "A",
        "authorized_official_last_name": "BROOKS",
        "authorized_official_first_name": "DENISE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CLINICAL PSYCHOLOGIST",
        "authorized_official_telephone_number": "734-446-5466",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSYD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6301014556",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plymouth, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2016; 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.