The Adult Psychiatric Clinic

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

1706446 Issued in MI

Legal business name

THE ADULT PSYCHIATRIC CLINIC

Practice address

17141 Ryan Rd
Detroit, MI 48212-1112

Phone

(313) 369-1717

Fax

(313) 369-1728

NPI assigned

Jul 28, 2006

Organization subpart

No

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

Authorized official

Name

Mr. William H. Peabody, MA, CSW

Title

Chief Executive Officer

Phone

(313) 369-1717

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• North Central Health Center Doing business as

Locations

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

{
    "created_epoch": "1154044800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1360713600000",
    "number": "1841204641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17141 RYAN RD",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482121112",
            "telephone_number": "313-369-1717",
            "fax_number": "313-892-0137"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17141 RYAN RD",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482121112",
            "telephone_number": "313-369-1717",
            "fax_number": "313-369-1728"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE ADULT PSYCHIATRIC CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-28",
        "last_updated": "2013-02-13",
        "status": "A",
        "authorized_official_last_name": "PEABODY",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "H.",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "313-369-1717",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MA, CSW"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "MI",
            "license": "1706446",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD ID",
            "identifier": "71020000H26282",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1706446",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "North Central Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Mental Health Counselor in Detroit, MI
• Providers in Detroit, MI by specialty
• Mental Health Counselor in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2013; 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.