Provider Demographics
NPI: | 1265192041 |
---|---|
Name: | DEENA D BATY LMSW |
Entity type: | Organization |
Organization Name: | DEENA D BATY LMSW |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | CORPORATE HEAD |
Authorized Official - Prefix: | |
Authorized Official - First Name: | DEENA |
Authorized Official - Middle Name: | D |
Authorized Official - Last Name: | BATY |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | LMSW |
Authorized Official - Phone: | 734-219-8380 |
Mailing Address - Street 1: | 1231 CLARITA ST |
Mailing Address - Street 2: | |
Mailing Address - City: | YPSILANTI |
Mailing Address - State: | MI |
Mailing Address - Zip Code: | 48198-6419 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 734-219-8380 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 588 PINEWOOD ST |
Practice Address - Street 2: | |
Practice Address - City: | YPSILANTI |
Practice Address - State: | MI |
Practice Address - Zip Code: | 48198-6108 |
Practice Address - Country: | US |
Practice Address - Phone: | 734-219-8380 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2021-12-21 |
Last Update Date: | 2021-12-21 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 101Y00000X | Behavioral Health & Social Service Providers | Counselor | Group - Multi-Specialty |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
MI | 1614298 | Other | BLUE CROSS BLUE SHIELD |