St. John Providence Community Health

Primary specialty

Adolescent and Children Mental Health Clinic/CenterTaxonomy code 261QM0855X

License

6401013184 Issued in MI

Legal business name

ST. JOHN PROVIDENCE COMMUNITY HEALTH

Practice address

11600 E 7 Mile Rd
Detroit, MI 48205-2112

Phone

(313) 372-5974

NPI assigned

Nov 5, 2015

Organization subpart

No

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

Authorized official

Name

Mr. Lonnie Harvey III

Title

Behavioral Health Counselor

Phone

(313) 372-5974

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1446681600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1447804800000",
    "number": "1902279466",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11600 E 7 MILE RD",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482052112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11600 E 7 MILE RD",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482052112",
            "telephone_number": "313-372-5974"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. JOHN PROVIDENCE COMMUNITY HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-11-05",
        "last_updated": "2015-11-18",
        "status": "A",
        "authorized_official_last_name": "HARVEY",
        "authorized_official_first_name": "LONNIE",
        "authorized_official_title_or_position": "BEHAVIORAL HEALTH COUNSELOR",
        "authorized_official_telephone_number": "313-372-5974",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "III"
    },
    "taxonomies": [
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": "MI",
            "license": "6401013184",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• St. John Hospital and Medical Center
• St. John Hospital and Medical Center
• St. John Hospital and Medical Center
• St. John Hospital and Medical Center
• St. John Hospital Corporation
• St. Joseph Medical Center PC
• St. Michael Nursing Center
• St. Patrick Senior Center, Inc
• St. Ruth'S House of Hope LLC
• St. Vincent de Paul Detroit Dental

• Adolescent and Children Mental Health Clinic/Center in Detroit, MI
• Providers in Detroit, MI by specialty
• Adolescent and Children Mental Health Clinic/Center in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 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.