Organization Active NPI

Changing Perceptions Therapy

  • Community/Behavioral Health Agency
  • Clinton TWP, MI
National Provider Identifier
1912273095
Registry record updated Jul 25, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
6301014870 Issued in MI
Legal business name
CHANGING PERCEPTIONS THERAPY
Practice address
18557 Canal Rd
Suite 3
Clinton TWP, MI 48038-5821
Phone
(586) 226-8440
Fax
(586) 226-8470
NPI assigned
Mar 22, 2012
Last updated
Jul 25, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2012

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

Authorized official

Name
Dr. Deborah Lynn Conrad-Garrisi, PHD LLPNPI 1982884367
Title
Psychologist
Phone
(586) 226-8440

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X 6301014870 MI Primary

Addresses

Primary practice location

18557 Canal Rd
Suite 3
Clinton TWP, MI 48038-5821

Mailing address

18557 Canal Rd
Suite 3
Clinton TWP, MI 48038-5821
Phone (586) 226-8440

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120725000077 MI Part B Supplier - Clinic/Group Practice 7315103009 Receives reassigned benefits from 2 practitioners
Practice locations: Clinton Township, MI

National Provider Directory

National Provider Directory

Locations

18557 Canal Rd
Ste 3
Clinton Twp, MI 48038
Phone (586) 226-8440

Practitioners & affiliated clinicians

Practitioners 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1332374400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1343174400000",
    "number": "1912273095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18557 CANAL RD",
            "address_2": "SUITE 3",
            "city": "CLINTON TWP",
            "state": "MI",
            "postal_code": "480385821",
            "telephone_number": "586-226-8440",
            "fax_number": "586-226-8470"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18557 CANAL RD",
            "address_2": "SUITE 3",
            "city": "CLINTON TWP",
            "state": "MI",
            "postal_code": "480385821",
            "telephone_number": "586-226-8440",
            "fax_number": "586-226-8470"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHANGING PERCEPTIONS THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-22",
        "last_updated": "2012-07-25",
        "status": "A",
        "authorized_official_last_name": "CONRAD-GARRISI",
        "authorized_official_first_name": "DEBORAH",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "PSYCHOLOGIST",
        "authorized_official_telephone_number": "586-226-8440",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD LLP"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "MI",
            "license": "6301014870",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clinton TWP, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.