Wandering Minds Therapy Collective

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

WANDERING MINDS THERAPY COLLECTIVE

Practice address

339 E Townline Lake Rd
Harrison, MI 48625-9278

Phone

(989) 272-3055

NPI assigned

Jan 9, 2025

Last updated

Jan 9, 2025By 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

Melissa E Reilley, LMSWNPI 1124628771

Title

Psychotherapist

Phone

(989) 272-3055

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 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.

• Melissa Elizabeth Reilley, LLMSW

  • Social Worker
  • Southfield, MI
  • NPI 1124628771

  Clinical

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1736380800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1736380800000",
    "number": "1689484990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1760 ABBEY RD STE 200",
            "city": "EAST LANSING",
            "state": "MI",
            "postal_code": "488237302",
            "telephone_number": "989-272-3055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "339 E TOWNLINE LAKE RD",
            "city": "HARRISON",
            "state": "MI",
            "postal_code": "486259278",
            "telephone_number": "989-272-3055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WANDERING MINDS THERAPY COLLECTIVE",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-01-09",
        "last_updated": "2025-01-09",
        "certification_date": "2025-01-09",
        "status": "A",
        "authorized_official_last_name": "REILLEY",
        "authorized_official_first_name": "MELISSA",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PSYCHOTHERAPIST",
        "authorized_official_telephone_number": "989-272-3055",
        "authorized_official_credential": "LMSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Phani Deepthi Vadlamudi, M.D.
• Deana Vanbuskirk, LMSW
• Melisa Catherine Wagner
• Jamie Walderzak
• Shane William Walker, LLCMSW
• Jane Wasserman
• Sydnee Sue Waters
• Ashley Watters
• Emily Rose Webb
• Sara Jane Wehrmeister, PHARMD

• Clinical Social Worker in Harrison, MI
• Providers in Harrison, 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 Jan 9, 2025; 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.