Positive Mindset Therapy, LLC

Organization Active NPI Clinical Social Worker · Grass Lake, MI

NPI 1740908474 · NPPES record last updated Aug 18, 2022

Key facts

NPI
1740908474
Entity type
Organization (NPI type 2)
Primary specialty
Clinical Social Worker 1041C0700X
Legal business name
POSITIVE MINDSET THERAPY, LLC
Practice address
12901 E Michigan Ave
Grass Lake, MI 49240-9283
Phone
(517) 240-1367
NPI assigned
Aug 18, 2022
Organization subpart
No

Authorized official

Name
Juanita Kay Meyerink, LMSW NPI 1356863484
Title
Owner
Phone
(517) 240-1367

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

Practitioners 1

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

Medicare participation

Medicare fee-for-service enrollment
Enrolled in MI

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20220912002703 MI Part B Supplier - Clinic/Group Practice 2860877883 Receives reassigned benefits from 1 practitioner
Practice locations: Jackson, MI

National Provider Directory

Locations

180 W Michigan Ave
Ste 703
Jackson, MI 49201
Phone (517) 240-1367

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker
Group: 193400000X SINGLE SPECIALTY GROUP
1041C0700X Yes

Addresses

Primary practice location

12901 E Michigan Ave
Grass Lake, MI 49240-9283

Mailing address

12901 E Michigan Ave
Grass Lake, MI 49240-9283
Phone (517) 240-1367

Other providers in Grass Lake, MI

All providers in Grass Lake, MI · Clinical Social Worker in Michigan

Sources for this page

Verify at the official NPI Registry.