By Moonlight and Tide Psychotherapy PLLC

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

BY MOONLIGHT AND TIDE PSYCHOTHERAPY PLLC

Practice address

2222 W Grand River Ave Ste a
Okemos, MI 48864-1604

Phone

(248) 266-0625

NPI assigned

May 15, 2025

Organization subpart

No

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

Authorized official

Name

Cassiann M Procenko, LMSW-CNPI 1881125060

Title

Clinical Director

Phone

(320) 310-8895

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Cassiann Procenko, LICSW

  • Clinical Social Worker
  • Rochester Hills, MI
  • NPI 1881125060
  NPD Authorized official

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

{
    "created_epoch": "1747267200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1747267200000",
    "number": "1912798174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "740 KIMBERLY APT 302",
            "city": "LAKE ORION",
            "state": "MI",
            "postal_code": "483622963",
            "telephone_number": "320-310-8895"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2222 W GRAND RIVER AVE STE A",
            "city": "OKEMOS",
            "state": "MI",
            "postal_code": "488641604",
            "telephone_number": "248-266-0625"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "740 Kimberly Apt 302",
            "address_purpose": "LOCATION",
            "city": "Lake Orion",
            "state": "MI",
            "postal_code": "483622963",
            "country_code": "US",
            "telephone_number": "248-266-0625",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "BY MOONLIGHT AND TIDE PSYCHOTHERAPY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-05-15",
        "last_updated": "2025-05-15",
        "certification_date": "2025-05-15",
        "status": "A",
        "authorized_official_last_name": "PROCENKO",
        "authorized_official_first_name": "CASSIANN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "320-310-8895",
        "authorized_official_credential": "LMSW-C"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Francesca Marie Buskulic, D.O.
• Connie Geralyn Bussey-Hooper, LMSW, QCSW, DCSW
• Karyn Geralyn Butler, FPMHNP-BC
• Kristin Marie Butler, CPHT
• Thomas Philip Buzzell
• Lily Margaret Caglianone, BEHAVIOR TECHNICIAN
• Leslie Calderon-Zuniga
• Amanda Elizabeth Callahan
• Terri Jo Cally, L.M.S.W.
• Joanne E Campbell, NURSE PRACTITIONER

• Mental Health Clinic/Center (Including Community Mental Health Center) in Okemos, MI
• Providers in Okemos, MI by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2025; 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.