NPIMap

Organization Active NPI

Goedert Therapeutic Services, LLC

  • Community/Behavioral Health Agency
  • Royal Oak, MI
National Provider Identifier
1780944967
Registry record updated May 22, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
6801089319 Issued in MI
Legal business name
GOEDERT THERAPEUTIC SERVICES, LLC
Practice address
415 S West St
Suite 150
Royal Oak, MI 48067-2521
Phone
(313) 850-0469
NPI assigned
May 22, 2012
Last updated
May 22, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 22, 2012

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

Authorized official

Name
Mead Goedert, LMSWNPI 1285920181
Title
Clinical Therapist
Phone
(313) 850-0469

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X 6801089319 MI Primary

Addresses

Primary practice location

415 S West St
Suite 150
Royal Oak, MI 48067-2521

Mailing address

415 S West St
Suite 150
Royal Oak, MI 48067-2521
Phone (313) 850-0469

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1337644800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1337644800000",
    "number": "1780944967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 S WEST ST",
            "address_2": "SUITE 150",
            "city": "ROYAL OAK",
            "state": "MI",
            "postal_code": "480672521",
            "telephone_number": "313-850-0469"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 S WEST ST",
            "address_2": "SUITE 150",
            "city": "ROYAL OAK",
            "state": "MI",
            "postal_code": "480672521",
            "telephone_number": "313-850-0469"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOEDERT THERAPEUTIC SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-22",
        "last_updated": "2012-05-22",
        "status": "A",
        "authorized_official_last_name": "GOEDERT",
        "authorized_official_first_name": "MEAD",
        "authorized_official_title_or_position": "CLINICAL THERAPIST",
        "authorized_official_telephone_number": "313-850-0469",
        "authorized_official_credential": "LMSW"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "MI",
            "license": "6801089319",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 May 22, 2012; 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.