NPIMap

Organization Active NPI

Henry Ford Health System

  • Adolescent and Children Mental Health Clinic/Center
  • Dearborn, MI
National Provider Identifier
1891075958
Registry record updated Aug 22, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adolescent and Children Mental Health Clinic/CenterTaxonomy code 261QM0855X
License
6301007252 Issued in MI
Legal business name
HENRY FORD HEALTH SYSTEM
Practice address
5111 Auto Club Dr
Suite 112 Bldig 5
Dearborn, MI 48126-2749
Phone
(313) 317-2000
Fax
(313) 317-2090
NPI assigned
Aug 22, 2011
Last updated
Aug 22, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2011

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

Authorized official

Name
Miss Judith M Malinowski, MA LLP
Title
Behavioral Health Therapist
Phone
(313) 317-2000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adolescent and Children Mental Health Clinic/Center 261QM0855X 6301007252 MI Primary

Addresses

Primary practice location

5111 Auto Club Dr
Suite 112 Bldig 5
Dearborn, MI 48126-2749

Mailing address

5111 Auto Club Dr
Suite 112 Bldig 5
Dearborn, MI 48126-2749
Phone (313) 317-2000

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1313971200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1313971200000",
    "number": "1891075958",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5111 AUTO CLUB DR",
            "address_2": "SUITE 112 BLDIG 5",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481262749",
            "telephone_number": "313-317-2000",
            "fax_number": "313-317-2090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5111 AUTO CLUB DR",
            "address_2": "SUITE 112 BLDIG 5",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481262749",
            "telephone_number": "313-317-2000",
            "fax_number": "313-317-2090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HENRY FORD HEALTH SYSTEM",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-08-22",
        "last_updated": "2011-08-22",
        "status": "A",
        "authorized_official_last_name": "MALINOWSKI",
        "authorized_official_first_name": "JUDITH",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "BEHAVIORAL HEALTH THERAPIST",
        "authorized_official_telephone_number": "313-317-2000",
        "authorized_official_name_prefix": "Miss",
        "authorized_official_credential": "MA LLP"
    },
    "taxonomies": [
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": "MI",
            "license": "6301007252",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dearborn, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2011; 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.