NPIMap

Organization Active NPI

Great Lakes Wellness Group

  • Clinical Psychologist
  • Ann Arbor, MI
National Provider Identifier
1972359057
Registry record updated Apr 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
Legal business name
GREAT LAKES WELLNESS GROUP
Practice address
231 Little Lake Dr Ste B
Ann Arbor, MI 48103-6247
Phone
(734) 249-8500
NPI assigned
Apr 29, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2024

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

Authorized official

Name
Sierra C Hillebrand, LLPNPI 1285907691
Title
President
Phone
(734) 330-3494

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 4

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X
Clinical PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC0700X Primary
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X
DoulaGroup: 193200000X MULTI-SPECIALTY GROUP 374J00000X

Addresses

Primary practice location

231 Little Lake Dr Ste B
Ann Arbor, MI 48103-6247

Mailing address

231 Little Lake Dr Ste B
Ann Arbor, MI 48103-6247
Phone (734) 249-8500

National Provider Directory

National Provider Directory

Locations

231 Little Lake Dr
Ste B
Ann Arbor, MI 48103
Phone (734) 249-8500

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": "1714348800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1714348800000",
    "number": "1972359057",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "231 LITTLE LAKE DR STE B",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481036247",
            "telephone_number": "734-249-8500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "231 LITTLE LAKE DR STE B",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481036247",
            "telephone_number": "734-249-8500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREAT LAKES WELLNESS GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-04-29",
        "last_updated": "2024-04-29",
        "certification_date": "2024-04-29",
        "status": "A",
        "authorized_official_last_name": "HILLEBRAND",
        "authorized_official_first_name": "SIERRA",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "734-330-3494",
        "authorized_official_credential": "LLP"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "374J00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Doula",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ann Arbor, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2024; 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.