Goedert Therapeutic Services, LLC

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

Organization subpart

No

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

Authorized official

Name

Mead Goedert, LMSW

Title

Clinical Therapist

Phone

(313) 850-0469

Specialties & licenses 1

Addresses

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": []
}

• Stefanie Marie Glasgow, DNP, CRNA
• Cole Samuel Gleason, MD
• Global Wellness Enterprises PLLC
• Global Wellness Inc
• Emma Rae Glover, DO
• Mead Goedert, LMSW
• George Thomas Goike Jr., LMSW
• Jeffrey M Gold, M.D.
• Linda Ellen Gold, L.M.S.W.
• Michal Goldberg, LMSW

• Community/Behavioral Health Agency in Royal Oak, MI
• Providers in Royal Oak, MI by specialty
• Community/Behavioral Health Agency in Michigan

• 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.