Montcalm Care Network
Organization Active NPI Community/Behavioral Health Agency · Stanton, MI
NPI 1710074448 · NPPES record last updated Feb 10, 2023
Key facts
- NPI
- 1710074448
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community/Behavioral Health Agency 251S00000X
- Legal business name
- MONTCALM CARE NETWORK
- Practice address
- 611 N State Street
Stanton, MI 48888 - Phone
- (989) 831-7520
- Fax
- (989) 831-7578
- NPI assigned
- Oct 6, 2006
- Organization subpart
- No
Authorized official
- Name
- Mr. James R Wise
- Title
- Associate Director of Finance
- Phone
- (989) 831-7577
Practitioners 31
-
Jodi Ferris, LPC
-
Perla Garza, LMSW
-
Vincent Kempinski, ANP-C
-
Samantha Fugate Kennedy, D.O.
-
Brian Daniel Smith, M.D.
-
Nicholas Austin, M.D.
-
Anjum Mujahid, MD
-
Emily Carol Barr, LMSW
-
Wendy Jo Zank, LMSW
-
Bryan E Bolen, DO
-
Laurie Jo Davis, NP-C, MSN, BSN, RN
-
Bethany Danielle Hintz, LLMSW
-
David E Lyon, DO
-
Nicole Alyse Vega, LMSW
-
Chidinma Isinguzo, M.D
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 23D2095713 | Montcalm Center for Behavioral Health | Certificate of waiver | May 10, 2027 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MI
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040623001391 | MI | Part B Supplier - Clinic/Group Practice | 8123000932 |
Receives reassigned benefits from 30 practitioners Practice locations: Stanton, MI |
National Provider Directory
Locations
108 N Lafayette St
Greenville, MI 48838
Phone (989) 831-7520
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Behavioral Health Agency | 251S00000X | Yes |
Addresses
Primary practice location
611 N State Street
Stanton, MI 48888
Mailing address
611 N State Street
Stanton, MI 48888
Phone (989) 831-7520
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1712461 | Medicaid | MI |
Other names
- The Montcalm Center for Behavioral Health
Other providers in Stanton, MI
- Mid-Michigan District Health Department
- Jill Marie Miller
- Phillip Millerov
- Morghan Minnick
- Montcalm Area Intermediate School District
- Montcalm County Commission on Aging
- Alicia Grace Moravik
- Julia L Morey
- Mariah Tess Morrow
- Amber Marie Morsey
All providers in Stanton, MI · Community/Behavioral Health Agency in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 10, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.