Central Care Management Organization

Primary specialty

Prevention ProfessionalTaxonomy code 405300000X

Legal business name

CENTRAL CARE MANAGEMENT ORGANIZATION

Doing business as

Center for Youth & Families

Practice address

3031 W Grand Blvd Ste 370
Detroit, MI 48202-3008

Phone

(313) 875-2092

Fax

(313) 875-2092

NPI assigned

Jan 6, 2021

Last updated

Jan 6, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Reginald Charles Terry Sr., MA, LPCNPI 1023279841

Title

Prevention Director

Phone

(313) 875-2092

Specialties & licenses 2

Addresses

Other names 1

• Center for Youth & Families Doing business as

Locations

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.

• Reginald Charles Terry, MA, LLPC, CAADC

  • Professional Counselor
  • New Baltimore, MI
  • NPI 1023279841
  NPD Authorized official

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

{
    "created_epoch": "1609891200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1609891200000",
    "number": "1790373579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3031 W GRAND BLVD STE 370",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482023008",
            "telephone_number": "313-875-2092",
            "fax_number": "313-875-2146"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3031 W GRAND BLVD STE 370",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482023008",
            "telephone_number": "313-875-2092",
            "fax_number": "313-875-2092"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRAL CARE MANAGEMENT ORGANIZATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-01-06",
        "last_updated": "2021-01-06",
        "certification_date": "2021-01-06",
        "status": "A",
        "authorized_official_last_name": "TERRY",
        "authorized_official_first_name": "REGINALD",
        "authorized_official_middle_name": "CHARLES",
        "authorized_official_title_or_position": "PREVENTION DIRECTOR",
        "authorized_official_telephone_number": "313-875-2092",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Sr.",
        "authorized_official_credential": "MA, LPC"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "405300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Prevention Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Center for Youth & Families",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Prevention Professional in Detroit, MI
• Providers in Detroit, MI by specialty
• Prevention Professional in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2021; 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.