NPIMap

Organization Active NPI

Integrative Mental Health & Wellness Services

  • Mental Health Counselor
  • Eastpointe, MI
National Provider Identifier
1821329681
Registry record updated Jan 19, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
6401011565 Issued in MI
Legal business name
INTEGRATIVE MENTAL HEALTH & WELLNESS SERVICES
Practice address
21261 Kelly Rd
Eastpointe, MI 48021-3125
Phone
(586) 771-7253
NPI assigned
Jan 19, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2010

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

Authorized official

Name
Mr. Jimmie Lovell Mabury
Title
Owner
Phone
(586) 771-7253

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X 6401011565 MI Primary

Addresses

Primary practice location

21261 Kelly Rd
Eastpointe, MI 48021-3125

Mailing address

21261 Kelly Rd
Eastpointe, MI 48021-3125
Phone (586) 771-7253

National Provider Directory

National Provider Directory
Tax ID family
Integrative Counseling Services LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1263859200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1263859200000",
    "number": "1821329681",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21261 KELLY RD",
            "city": "EASTPOINTE",
            "state": "MI",
            "postal_code": "480213125",
            "telephone_number": "586-771-7253"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21261 KELLY RD",
            "city": "EASTPOINTE",
            "state": "MI",
            "postal_code": "480213125",
            "telephone_number": "586-771-7253"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRATIVE MENTAL HEALTH & WELLNESS SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-01-19",
        "last_updated": "2010-01-19",
        "status": "A",
        "authorized_official_last_name": "MABURY",
        "authorized_official_first_name": "JIMMIE",
        "authorized_official_middle_name": "LOVELL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "586-771-7253",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "MI",
            "license": "6401011565",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eastpointe, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2010; 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.