Proactive Mental Health Services, LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

PROACTIVE MENTAL HEALTH SERVICES, LLC

Practice address

45184 Cass Ave
Utica, MI 48317-5507

Phone

(586) 930-5590

NPI assigned

Mar 12, 2016

Last updated

Jul 24, 2016By 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

Dr. Lisa Demopoulos, PSY.D., LLP, LMSW

Title

Co-Owner

Phone

(586) 219-4782

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1457740800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1469318400000",
    "number": "1841651270",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45184 CASS AVE",
            "city": "UTICA",
            "state": "MI",
            "postal_code": "483175507",
            "telephone_number": "586-930-5590"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45184 CASS AVE",
            "city": "UTICA",
            "state": "MI",
            "postal_code": "483175507",
            "telephone_number": "586-930-5590"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROACTIVE MENTAL HEALTH SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-12",
        "last_updated": "2016-07-24",
        "status": "A",
        "authorized_official_last_name": "DEMOPOULOS",
        "authorized_official_first_name": "LISA",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "586-219-4782",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSY.D., LLP, LMSW"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bernadine A. Pickett, M.A., L.P.C, NCC
• Rhyzianne Pimental
• Polanski Quinn and Associates PLLC
• Rebecca Polanski, MA, TLLP
• Jake Pradko, LPC
• Procare Essential LLC
• Ariel Paige Pscheidl, OD
• Samantha Qarana, LMSW
• Genna Ramey, DDS
• Sheila Marie Ramos, PHYSICAL THERAPIST

• Community/Behavioral Health Agency in Utica, MI
• Providers in Utica, 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 Jul 24, 2016; 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.