DOWNRIVER MENTAL HEALTH CLINIC PC

Provider Demographics

• NPI: 1225165715
• Name: DOWNRIVER MENTAL HEALTH CLINIC PC
• Entity Type: Organization
• Organization Name: DOWNRIVER MENTAL HEALTH CLINIC PC
• Other - Org Name: ADVANCED COUNSELING SERVICES PC
• Other - Org Type: Doing Business As
• Authorized Official - Title/Position: CHIEF LEGAL OFFICER
• Authorized Official - First Name: RYAN
• Authorized Official - Last Name: PARDO
• Authorized Official - Phone: 206-399-1493
• Mailing Address - Street 1: 20600 EUREKA RD
• Mailing Address - Street 2: SUITE 819
• Mailing Address - City: TAYLOR
• Mailing Address - State: MI
• Mailing Address - Zip Code: 48180-5343
• Mailing Address - Country: US
• Mailing Address - Phone: 734-285-8282
• Practice Address - Street 1: 7600 GRAND RIVER RD
• Practice Address - Street 2: SUITE 290
• Practice Address - City: BRIGHTON
• Practice Address - State: MI
• Practice Address - Zip Code: 48114-7333
• Practice Address - Country: US
• Practice Address - Phone: 810-220-2787
• Practice Address - Fax: 810-220-2834
• EIN: <UNAVAIL>
• Is Organization Subpart?: No
• Enumeration Date: 2007-02-28
• Last Update Date: 2024-03-01

Provider Taxonomies

Primary?	Code	Type	Classification	Specialization	Group
Yes	103T00000X	Behavioral Health & Social Service Providers	Psychologist		Group - Multi-Specialty
No	101YM0800X	Behavioral Health & Social Service Providers	Counselor	Mental Health	Group - Multi-Specialty
No	1041C0700X	Behavioral Health & Social Service Providers	Social Worker	Clinical	Group - Multi-Specialty
No	261QM0801X	Ambulatory Health Care Facilities	Clinic/Center	Mental Health (Including Community Mental Health Center)	Group - Multi-Specialty

Provider Identifiers

State	Identifier ID	ID Type	Issuer
MI	004241F3	Other	HAP
MI	7509108990	Other	BLUE CROSS BLUE SHIELD
MI	BM820042	Other	MCARE
MI	4441728	Other	TEAMSTERS
MI	511213	Other	PREFERRED CHOICES
MI	101039	Other	VALUE OPTIONS
MI	188710000	Other	MAGELLAN STATE OF MI
MI	511213	Other	CARE CHOICES
MI	4449395	Other	AETNA
MI	188710000	Other	MAGELLAN STATE OF MI
MI	511213	Other	CARE CHOICES
MI	511213	Other	PREFERRED CHOICES
MI	=========	Other	TRICARE
MI	=========	Other	CIGNA
MI	=========	Other	TRICARE
MI	=========	Other	CIGNA
MI	188710000	Other	MAGELLAN STATE OF MI
MI	4441728	Other	TEAMSTERS
MI	=========	Other	BCN