Healthy Mind Healthy Life

Primary specialty

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

Legal business name

HEALTHY MIND HEALTHY LIFE

Practice address

17515 W 9 Mile Rd Ste 650
Southfield, MI 48075-4403

Phone

(248) 963-8189

Fax

(763) 402-7611

NPI assigned

Apr 26, 2022

Last updated

Nov 8, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Larissa Barclay, DNP, NP-C, PMHNP-BCNPI 1649473786

Title

Owner

Phone

(248) 963-8189

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Locations

Practitioners 1

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.

• Larissa Barclay, DNP, NP-C, PMHNP-BC

  • Nurse Practitioner
  • Southfield, MI
  • NPI 1649473786
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1650931200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1699401600000",
    "number": "1932843984",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17515 W 9 MILE RD STE 650",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480754403",
            "telephone_number": "313-633-8385",
            "fax_number": "763-402-7611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17515 W 9 MILE RD STE 650",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480754403",
            "telephone_number": "248-963-8189",
            "fax_number": "763-402-7611"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "17515 W 9 Mile Rd Ste 650",
            "address_purpose": "LOCATION",
            "city": "Southfield",
            "state": "MI",
            "postal_code": "480754403",
            "country_code": "US",
            "telephone_number": "248-963-8189",
            "fax_number": "763-402-7611",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "HEALTHY MIND HEALTHY LIFE",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-04-26",
        "last_updated": "2023-11-08",
        "certification_date": "2023-11-08",
        "status": "A",
        "authorized_official_last_name": "BARCLAY",
        "authorized_official_first_name": "LARISSA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "248-963-8189",
        "authorized_official_credential": "DNP, NP-C, PMHNP-BC"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Clinic/Center (Including Community Mental Health Center) in Southfield, MI
• Providers in Southfield, 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 Nov 8, 2023; 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.