Provider Demographics
NPI:1265556161
Name:THERAPEUTIC ENCOUNTERS PC
Entity type:Organization
Organization Name:THERAPEUTIC ENCOUNTERS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:XAVIER
Authorized Official - Middle Name:
Authorized Official - Last Name:WHITE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:313-832-0870
Mailing Address - Street 1:3800 WOODWARD AVE
Mailing Address - Street 2:SUITE 202
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48201-2061
Mailing Address - Country:US
Mailing Address - Phone:313-832-0870
Mailing Address - Fax:313-832-6024
Practice Address - Street 1:3800 WOODWARD AVE
Practice Address - Street 2:SUITE 202
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48201-2061
Practice Address - Country:US
Practice Address - Phone:313-832-0870
Practice Address - Fax:313-832-6024
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIXW4053762084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI103421OtherGREAT LAKES HMO
MIXW405376OtherMI ST LIC #
MI2093489OtherCIGNA HEALTH INS
MI3242604Medicaid
MIP00082403OtherPALMETTO RR MEDICARE
MIG22932OtherHAP
MI10043320001OtherWELLNESS PLAN
MIXW405376OtherMI ST LIC #
MIP00082403OtherPALMETTO RR MEDICARE