Phase Mental Health and Wellness LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

PHASE MENTAL HEALTH AND WELLNESS LLC

Practice address

888 W Big Beaver Rd Ste 780
Troy, MI 48084-4745

Phone

(248) 406-6756

NPI assigned

Jan 16, 2023

Last updated

Jul 31, 2023By 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

Courtney Godbout, LMSW-CNPI 1053659268

Title

Founder

Phone

(248) 245-0665

Specialties & licenses 1

Addresses

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.

• Courtney Billington Godbout

  • Clinical Social Worker
  • Troy, MI
  • NPI 1053659268
  Authorized official Same address or phone

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

{
    "created_epoch": "1673827200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1690761600000",
    "number": "1821703844",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "888 W BIG BEAVER RD STE 780",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480844745",
            "telephone_number": "248-406-6756"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "888 W BIG BEAVER RD STE 780",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480844745",
            "telephone_number": "248-406-6756"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "320 Romeo Rd",
            "address_purpose": "LOCATION",
            "city": "Rochester",
            "state": "MI",
            "postal_code": "483071560",
            "country_code": "US",
            "telephone_number": "248-245-0665",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PHASE MENTAL HEALTH AND WELLNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-01-16",
        "last_updated": "2023-07-31",
        "certification_date": "2023-07-31",
        "status": "A",
        "authorized_official_last_name": "GODBOUT",
        "authorized_official_first_name": "COURTNEY",
        "authorized_official_title_or_position": "FOUNDER",
        "authorized_official_telephone_number": "248-245-0665",
        "authorized_official_credential": "LMSW-C"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Kellie Phillips
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• Physical Therapy Center for Sports and Performing Arts, PLLC

• Clinical Social Worker in Troy, MI
• Providers in Troy, MI by specialty
• Clinical Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2023; 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.