Organization Active NPI

Spiritual Fitness LLC

Doing business as Body Spirit Mind

  • Clinical Social Worker
  • Ann Arbor, MI
National Provider Identifier
1740857317
Registry record updated Aug 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
SPIRITUAL FITNESS LLC
Doing business as
Body Spirit Mind
Practice address
206 S Main St Ste 201
Ann Arbor, MI 48104-2114
Phone
(313) 479-4605
NPI assigned
Jun 10, 2021
Last updated
Aug 7, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2023

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

Authorized official

Name
Ms. Poonam Sripada, LMSW, CAADCNPI 1174889539
Title
Owner
Phone
(313) 479-4605

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 Worker 1041C0700X NU Primary

Addresses

Primary practice location

206 S Main St Ste 201
Ann Arbor, MI 48104-2114

Mailing address

206 S Main St Ste 201
Ann Arbor, MI 48104-2114
Phone (313) 479-4605

Other practice location 1

29551 Greenfield Rd Ste 208
Southfield, MI 48076-5872
Phone (313) 479-4605

Other names 1

  • Body Spirit Mind Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220419000284 MI Part B Supplier - Clinic/Group Practice 0244627495 Receives reassigned benefits from 1 practitioner
Practice locations: Ann Arbor, MI

National Provider Directory

National Provider Directory

Locations

206 S Main St
Ste 201
Ann Arbor, MI 48104
Phone (248) 633-6902

29551 Greenfield Rd
Ste 208
Southfield, MI 48076
Phone (248) 744-6001

Practitioners & affiliated clinicians

Practitioners 3

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": "1623283200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1691366400000",
    "number": "1740857317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "206 S MAIN ST STE 201",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481042114",
            "telephone_number": "313-479-4605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "206 S MAIN ST STE 201",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481042114",
            "telephone_number": "313-479-4605"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "29551 Greenfield Rd Ste 208",
            "address_purpose": "LOCATION",
            "city": "Southfield",
            "state": "MI",
            "postal_code": "480765872",
            "country_code": "US",
            "telephone_number": "313-479-4605",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SPIRITUAL FITNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-10",
        "last_updated": "2023-08-07",
        "certification_date": "2023-08-07",
        "status": "A",
        "authorized_official_last_name": "SRIPADA",
        "authorized_official_first_name": "POONAM",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "313-479-4605",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LMSW, CAADC"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Body Spirit Mind",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Ann Arbor, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2023; 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.