NPIMap

Organization Active NPI

Grand Blanc Therapy

  • Social Worker
  • Grand Blanc, MI
National Provider Identifier
1922389477
Registry record updated Aug 29, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
6801085260 Issued in MI
Legal business name
GRAND BLANC THERAPY
Practice address
8323 Office Park Dr
Suite B
Grand Blanc, MI 48439-2068
Phone
(810) 659-7242
Fax
(810) 953-3116
NPI assigned
Aug 29, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2011

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

Authorized official

Name
Yvonne Makidon
Title
Owner
Phone
(810) 659-7242

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 104100000X 6801085260 MI Primary

Addresses

Primary practice location

8323 Office Park Dr
Suite B
Grand Blanc, MI 48439-2068

Mailing address

8323 Office Park Dr
Suite B
Grand Blanc, MI 48439-2068
Phone (810) 659-7242

National Provider Directory

National Provider Directory

Locations

8323 Office Park Dr
Ste B
Grand Blanc, MI 48439
Phone (810) 659-7242

NPI Registry JSON

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

{
    "created_epoch": "1314576000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1314576000000",
    "number": "1922389477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8323 OFFICE PARK DR",
            "address_2": "SUITE B",
            "city": "GRAND BLANC",
            "state": "MI",
            "postal_code": "484392068",
            "telephone_number": "810-659-7242",
            "fax_number": "810-953-3116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8323 OFFICE PARK DR",
            "address_2": "SUITE B",
            "city": "GRAND BLANC",
            "state": "MI",
            "postal_code": "484392068",
            "telephone_number": "810-659-7242",
            "fax_number": "810-953-3116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRAND BLANC THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-08-29",
        "last_updated": "2011-08-29",
        "status": "A",
        "authorized_official_last_name": "MAKIDON",
        "authorized_official_first_name": "YVONNE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "810-659-7242"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker",
            "state": "MI",
            "license": "6801085260",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Blanc, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 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.