Deanna's Therapeutic Massage LLC

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

7501000594 Issued in MI

Legal business name

DEANNA'S THERAPEUTIC MASSAGE LLC

Practice address

7938 Cooley Lake Rd
Suite 400W
Waterford, MI 48327-4404

Phone

(248) 345-6475

NPI assigned

Jan 26, 2015

Last updated

Jan 26, 2015By 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

Deanna Goodwin, C.M.T.NPI 1053701383

Title

Owner

Phone

(248) 345-6475

Specialties & licenses 1

Addresses

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.

• Deanna Goodwin, C.M.T.

  • Massage Therapist
  • Waterford, MI
  • NPI 1053701383
  NPD (past) Authorized official

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

{
    "created_epoch": "1422230400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1422230400000",
    "number": "1841680188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7938 COOLEY LAKE RD",
            "address_2": "SUITE 400W",
            "city": "WATERFORD",
            "state": "MI",
            "postal_code": "483274404",
            "telephone_number": "248-345-6475"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7938 COOLEY LAKE RD",
            "address_2": "SUITE 400W",
            "city": "WATERFORD",
            "state": "MI",
            "postal_code": "483274404",
            "telephone_number": "248-345-6475"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEANNA'S THERAPEUTIC MASSAGE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-01-26",
        "last_updated": "2015-01-26",
        "status": "A",
        "authorized_official_last_name": "GOODWIN",
        "authorized_official_first_name": "DEANNA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "248-345-6475",
        "authorized_official_credential": "C.M.T."
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "MI",
            "license": "7501000594",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shannon Lea Davis, OTR/L
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• Victoria Ann Deflorio, NURSE PRACTITIONER
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• Mark Degroff
• Melissa Degroff, LMSW

• Massage Therapist in Waterford, MI
• Providers in Waterford, MI by specialty
• Massage Therapist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2015; 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.