Organization Active NPI

Trauma and Mood Recovery Center LLC

  • Social Worker
  • Frankenmuth, MI
National Provider Identifier
1932869591
Registry record updated Nov 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
Legal business name
TRAUMA AND MOOD RECOVERY CENTER LLC
Practice address
5 Wickson CT
Frankenmuth, MI 48734-1142
Phone
(989) 482-1996
NPI assigned
Dec 23, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2024

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

Authorized official

Name
Mary Beth Houpt
Title
Credentialing
Phone
(517) 676-9797

Specialties & licenses 1

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

Addresses

Primary practice location

5 Wickson CT
Frankenmuth, MI 48734-1142

Mailing address

5 Wickson CT
Frankenmuth, MI 48734-1142

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220106001778 MI Part B Supplier - Clinic/Group Practice 7012308752 Receives reassigned benefits from 1 practitioner
Practice locations: Frankenmuth, MI

National Provider Directory

National Provider Directory

Locations

6855 Junction Rd
Bridgeport, MI 48722
Phone (989) 482-1996

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1640217600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1731542400000",
    "number": "1932869591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 WICKSON CT",
            "city": "FRANKENMUTH",
            "state": "MI",
            "postal_code": "487341142"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 WICKSON CT",
            "city": "FRANKENMUTH",
            "state": "MI",
            "postal_code": "487341142",
            "telephone_number": "989-482-1996"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRAUMA AND MOOD RECOVERY CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-12-23",
        "last_updated": "2024-11-14",
        "certification_date": "2024-11-14",
        "status": "A",
        "authorized_official_last_name": "HOUPT",
        "authorized_official_first_name": "MARY BETH",
        "authorized_official_title_or_position": "CREDENTIALING",
        "authorized_official_telephone_number": "517-676-9797"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Frankenmuth, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2024; 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.