NPIMap

Organization Active NPI

Emerge Therapy, PLC

Doing business as Emerge Teletherapy Practice

  • Adult Mental Health Clinic/Center
  • Southfield, MI
National Provider Identifier
1699408674
Registry record updated Sep 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X
Legal business name
EMERGE THERAPY, PLC
Doing business as
Emerge Teletherapy Practice
Practice address
17145 Bonstelle Ave
Southfield, MI 48075-3470
Phone
(248) 945-2095
NPI assigned
Jul 6, 2022
Last updated
Sep 28, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2023

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

Authorized official

Name
Mia Michelle Hall, LMSWNPI 1629437769
Title
Clinical Mental Health Therapist
Phone
(248) 945-2095

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X NU
Adult Mental Health Clinic/Center 261QM0850X NU Primary
Adolescent and Children Mental Health Clinic/Center 261QM0855X NU

Addresses

Primary practice location

17145 Bonstelle Ave
Southfield, MI 48075-3470

Mailing address

17145 Bonstelle Ave
Southfield, MI 48075-3470
Phone (248) 996-4917

Other names 1

  • Emerge Teletherapy Practice Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1657065600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1695859200000",
    "number": "1699408674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17145 BONSTELLE AVE",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480753470",
            "telephone_number": "248-996-4917"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17145 BONSTELLE AVE",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480753470",
            "telephone_number": "248-945-2095"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EMERGE THERAPY, PLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-07-06",
        "last_updated": "2023-09-28",
        "certification_date": "2023-09-28",
        "status": "A",
        "authorized_official_last_name": "HALL",
        "authorized_official_first_name": "MIA",
        "authorized_official_middle_name": "MICHELLE",
        "authorized_official_title_or_position": "CLINICAL MENTAL HEALTH THERAPIST",
        "authorized_official_telephone_number": "248-945-2095",
        "authorized_official_credential": "LMSW"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Emerge Teletherapy Practice",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Emerge Teletherapy Practice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Southfield, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2023; 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.