Provider Demographics
| NPI: | 1174511372 |
|---|---|
| Name: | BART ANTHONY PC |
| Entity Type: | Organization |
| Organization Name: | BART ANTHONY PC |
| Other - Org Name: | THE COUNSELING CENTRE |
| Other - Org Type: | Doing Business As |
| Authorized Official - Title/Position: | PRESIDENT OWNER |
| Authorized Official - Prefix: | |
| Authorized Official - First Name: | BART |
| Authorized Official - Middle Name: | |
| Authorized Official - Last Name: | ANTHONY |
| Authorized Official - Suffix: | |
| Authorized Official - Credentials: | MA LLP |
| Authorized Official - Phone: | 248-338-2988 |
| Mailing Address - Street 1: | 43996 WOODWARD AVE |
| Mailing Address - Street 2: | STE 101 |
| Mailing Address - City: | BLOOMFIELD HILLS |
| Mailing Address - State: | MI |
| Mailing Address - Zip Code: | 48302-5027 |
| Mailing Address - Country: | US |
| Mailing Address - Phone: | 248-338-2988 |
| Mailing Address - Fax: | 248-338-1322 |
| Practice Address - Street 1: | 43996 WOODWARD AVE |
| Practice Address - Street 2: | STE 101 |
| Practice Address - City: | BLOOMFIELD HILLS |
| Practice Address - State: | MI |
| Practice Address - Zip Code: | 48302-5027 |
| Practice Address - Country: | US |
| Practice Address - Phone: | 248-338-2988 |
| Practice Address - Fax: | 248-338-1322 |
| EIN: | <UNAVAIL> |
| Is Organization Subpart?: | No |
| Parent Organization LBN: | |
| Parent Organization TIN: | |
| Enumeration Date: | 2005-10-11 |
| Last Update Date: | 2008-07-10 |
| Deactivation Date: | |
| Deactivation Code: | |
| Reactivation Date: |
Provider Licenses
| State | License ID | Taxonomies |
|---|---|---|
| MI | 631300 | 101YA0400X, 101YM0800X, 103TB0200X, 103TC0700X, 103TF0000X, 103TP2701X, 1041C0700X, 106H00000X |
Provider Taxonomies
| Primary? | Code | Type | Classification | Specialization | Group |
|---|---|---|---|---|---|
| Yes | 103TC0700X | Behavioral Health & Social Service Providers | Psychologist | Clinical | Group - Multi-Specialty |
| No | 101YA0400X | Behavioral Health & Social Service Providers | Counselor | Addiction (Substance Use Disorder) | Group - Multi-Specialty |
| No | 101YM0800X | Behavioral Health & Social Service Providers | Counselor | Mental Health | Group - Multi-Specialty |
| No | 103TB0200X | Behavioral Health & Social Service Providers | Psychologist | Cognitive & Behavioral | Group - Multi-Specialty |
| No | 103TF0000X | Behavioral Health & Social Service Providers | Psychologist | Family | Group - Multi-Specialty |
| No | 103TP2701X | Behavioral Health & Social Service Providers | Psychologist | Group Psychotherapy | Group - Multi-Specialty |
| No | 1041C0700X | Behavioral Health & Social Service Providers | Social Worker | Clinical | Group - Multi-Specialty |
| No | 106H00000X | Behavioral Health & Social Service Providers | Marriage & Family Therapist | Group - Multi-Specialty |
Provider Identifiers
| State | Identifier ID | ID Type | Issuer |
|---|---|---|---|
| MI | 028363 | Other | VALUE OPTIONS |
| MI | 0911419 | Other | BCBSM MESSA/ MAGELLAN |
| MI | 130958 | Other | CARE CHOICES & PREFERRED |
| MI | 1705289 | Medicaid | |
| MI | 20530 | Other | BCBSM SUBSTANCE ABUSE PIN |
| MI | 7509104190 | Other | BCBSM MENTAL HEALTH PIN |
| MI | 5266701 | Other | AETNA BEHAVIORAL HEALTH |
| MI | 1063603106 | Other | HEALTH PLUS PIN |
| MI | 258694 | Other | MHN PIN |
| MI | 20530 | Other | BCBSM SUBSTANCE ABUSE PIN |
| MI | 1705289 | Medicaid | |
| MI | 258694 | Other | MHN PIN |
| MI | 1063603106 | Other | HEALTH PLUS PIN |
| MI | 028363 | Other | VALUE OPTIONS |
