Active NPI
Resilient Mental Health
- Clinical Psychologist
- Traverse City, MI
National Provider Identifier
1982358719
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- Legal business name
- RESILIENT MENTAL HEALTH
- Practice address
- 4020 Copper VW Ste 104F
Traverse City, MI 49684-7041 - Phone
- (231) 714-4086
- NPI assigned
- Feb 10, 2022
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Diana Ro, PSYD
- Title
- Psychologist
- Phone
- (231) 714-4086
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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | Primary |
Addresses
Primary practice location
4020 Copper VW Ste 104F
Traverse City, MI 49684-7041
Mailing address
4020 Copper VW Ste 104F
Traverse City, MI 49684-7041
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | Luminello | Direct |
National Provider Directory
National Provider DirectoryLocations
4020 Copper Vw
Ste 104F
Traverse City, MI 49684
Phone (231) 714-4086
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Clinical Psychologist
- Traverse City, MI
- NPI 1144657800
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1644451200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1657497600000",
"number": "1982358719",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4020 COPPER VW STE 104F",
"city": "TRAVERSE CITY",
"state": "MI",
"postal_code": "496847041"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4020 COPPER VW STE 104F",
"city": "TRAVERSE CITY",
"state": "MI",
"postal_code": "496847041",
"telephone_number": "231-714-4086"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "RESILIENT MENTAL HEALTH",
"organizational_subpart": "NO",
"enumeration_date": "2022-02-10",
"last_updated": "2022-07-11",
"certification_date": "2022-07-11",
"status": "A",
"authorized_official_last_name": "RO",
"authorized_official_first_name": "DIANA",
"authorized_official_title_or_position": "PSYCHOLOGIST",
"authorized_official_telephone_number": "231-714-4086",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "PSYD"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Psychologist, Clinical",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "OTHERS",
"endpointTypeDescription": "Other URL",
"endpoint": "Luminello",
"affiliation": "N",
"endpointDescription": "EMR",
"use": "DIRECT",
"useDescription": "Direct",
"address_1": "9317 E Summerfield Dr",
"city": "Traverse City",
"state": "MI",
"country_code": "US",
"postal_code": "496847538",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Traverse City, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.