NPIMap

Organization Active NPI

Mitten Center for Psychological Trauma, LLC

  • Clinical Social Worker
  • Saint Clair Shores, MI
National Provider Identifier
1740750736
Registry record updated Jul 9, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
MITTEN CENTER FOR PSYCHOLOGICAL TRAUMA, LLC
Doing business as
Mitten Center for Psychological Trauma
Practice address
28800 Harper Ave Ste a
Saint Clair Shores, MI 48081
Phone
(586) 350-0013
Fax
(586) 350-0042
NPI assigned
Dec 3, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2019

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

Authorized official

Name
Terra Laquay Ginther, LMSWNPI 1669995783
Title
Coo
Phone
(248) 720-9833

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X Primary

Addresses

Primary practice location

28800 Harper Ave Ste a
Saint Clair Shores, MI 48081

Mailing address

28800 Harper Ave Ste a
Saint Clair Shores, MI 48081-1249
Phone (586) 350-0013

Other practice location 1

28800 Harper Ave Ste A
Saint Clair Shores, MI 48081
Phone (586) 350-0013

Other names 1

  • Mitten Center for Psychological Trauma Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1543795200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1562630400000",
    "number": "1740750736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28800 HARPER AVE STE A",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "480811249",
            "telephone_number": "586-350-0013",
            "fax_number": "586-350-0013"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28800 HARPER AVE STE A",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "48081",
            "telephone_number": "586-350-0013",
            "fax_number": "586-350-0042"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "28800 Harper Ave Ste A",
            "address_purpose": "LOCATION",
            "city": "Saint Clair Shores",
            "state": "MI",
            "postal_code": "48081",
            "country_code": "US",
            "telephone_number": "586-350-0013",
            "fax_number": "586-350-0042",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MITTEN CENTER FOR PSYCHOLOGICAL TRAUMA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-12-03",
        "last_updated": "2019-07-09",
        "status": "A",
        "authorized_official_last_name": "GINTHER",
        "authorized_official_first_name": "TERRA",
        "authorized_official_middle_name": "LAQUAY",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "248-720-9833",
        "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": [
        {
            "organization_name": "Mitten Center for Psychological Trauma",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Saint Clair Shores, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 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.