Reflections Community Service Program LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

REFLECTIONS COMMUNITY SERVICE PROGRAM LLC

Practice address

323 N Morrison St
Appleton, WI 54911-5404

Phone

(920) 840-6247

NPI assigned

Jun 24, 2022

Organization subpart

Yes

Parent organization

MACHT VILLAGE PROGRAMSAs reported in NPPES

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

Authorized official

Name

Mr. Devante Blanks, BA

Title

Founder/President

Phone

(773) 851-7381

Specialties & licenses 1

Addresses

Electronic endpoints 2

Part of

Macht Village Programs

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Macht Village Programs

  • Community/Behavioral Health Agency
  • De Pere, WI
  • NPI 1245697861
  NPPES parent name

Practitioners 2

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

• Mary Macht, LCSW;PH.D

  • Clinical Social Worker
  • De Pere, WI
  • NPI 1467812925
  NPD (past)
• Laura Phillips, LCSW

  • Clinical Social Worker
  • De Pere, WI
  • NPI 1467819953
  NPD (past)

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

{
    "created_epoch": "1656028800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1656028800000",
    "number": "1609508183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3310 MID VALLEY DR",
            "city": "DE PERE",
            "state": "WI",
            "postal_code": "541159495",
            "telephone_number": "920-469-9646"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "323 N MORRISON ST",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549115404",
            "telephone_number": "920-840-6247"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REFLECTIONS COMMUNITY SERVICE PROGRAM LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MACHT VILLAGE PROGRAMS",
        "enumeration_date": "2022-06-24",
        "last_updated": "2022-06-24",
        "certification_date": "2022-06-24",
        "status": "A",
        "authorized_official_last_name": "BLANKS",
        "authorized_official_first_name": "DEVANTE",
        "authorized_official_title_or_position": "FOUNDER/PRESIDENT",
        "authorized_official_telephone_number": "773-851-7381",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "BA"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "blanks@reflectionsprogram.net",
            "affiliation": "N",
            "address_1": "323 N Morrison St",
            "city": "Appleton",
            "state": "WI",
            "country_code": "US",
            "postal_code": "549115404",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jgettelman@machtvillage.com",
            "affiliation": "Y",
            "affiliationName": "Macht Village Programs Incorporated",
            "address_1": "3310 Mid Valley Dr",
            "city": "DE Pere",
            "state": "WI",
            "country_code": "US",
            "postal_code": "541159495",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Deeann D B Reece, MD
• Amanda Anne Reed
• Jennifer Marie Langman Reese, PA-C
• Terry William Reese, LPC, CSAC
• Reflection, LLC
• Reform Chiropractic LLC
• Refuge Counseling Center LLC
• Mark Gordon Regnier, PHARM.D.
• Rehabtech Inc
• Mark William Reich, MS PSYCHOLOGY

• Community/Behavioral Health Agency in Appleton, WI
• Providers in Appleton, WI by specialty
• Community/Behavioral Health Agency in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2022; 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.