NPIMap

Organization Active NPI

Ascension Eastwood Behavioral Health

  • Psychologist
  • Royal Oak, MI
National Provider Identifier
1740408244
Registry record updated Sep 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
Legal business name
ASCENSION EASTWOOD BEHAVIORAL HEALTH
Practice address
30701 Woodward Avenue
Suite 200
Royal Oak, MI 48073-0987
Phone
(248) 288-9333
Fax
(248) 288-1362
NPI assigned
Apr 23, 2007
Organization subpart
Yes
Parent organization
EASTWOOD COMMUNITY CLINICSAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 16, 2019

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

Authorized official

Name
Steven Candela, LMSW
Title
Director
Phone
(586) 753-0400

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
CounselorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 101Y00000X
PsychologistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 103T00000X Primary
Social WorkerGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 104100000X
Marriage & Family TherapistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 106H00000X
Psychiatry PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 2084P0800X

Addresses

Primary practice location

30701 Woodward Avenue
Suite 200
Royal Oak, MI 48073-0987

Mailing address

28000 Dequindre Rd
Warren, MI 48092-2468
Phone (586) 753-0405

Other names 1

  • Eastwood Clinics Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Eastwood Clinic23 organizations share this tax ID, including this one
Part of
Eastwood Clinic

Other organizations with this tax ID 22

Organizations that report the same tax identification number in the National Provider Directory.

View all 22

Locations

30701 Woodward Ave
Ste 200
Royal Oak, MI 48073
Phone (248) 288-9333

Ownership & related parties

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.

NPI Registry JSON

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

{
    "created_epoch": "1177286400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1568592000000",
    "number": "1740408244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28000 DEQUINDRE RD",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480922468",
            "telephone_number": "586-753-0405",
            "fax_number": "586-753-0404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30701 WOODWARD AVENUE",
            "address_2": "SUITE 200",
            "city": "ROYAL OAK",
            "state": "MI",
            "postal_code": "480730987",
            "telephone_number": "248-288-9333",
            "fax_number": "248-288-1362"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ASCENSION EASTWOOD BEHAVIORAL HEALTH",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "EASTWOOD COMMUNITY CLINICS",
        "enumeration_date": "2007-04-23",
        "last_updated": "2019-09-16",
        "status": "A",
        "authorized_official_last_name": "CANDELA",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "586-753-0400",
        "authorized_official_credential": "LMSW"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "104100000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Eastwood Clinics",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Eastwood Clinics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Royal Oak, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2019; 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.