Organization
COMMUNITY MENTAL HEALTH FOR CENTRAL MICHIGAN
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRYAN KROGMAN (EXECUTIVE DIRECTOR)
(989) 772-5930
Entity
Organization
Contact information
Practice address
301 S CRAPO ST, SUITE 100, MT PLEASANT, MI 48858-2941
(989) 773-6961
(989) 773-1968
Mailing address
301 S CRAPO ST, SUITE 100, MT PLEASANT, MI 48858-2941
(989) 773-6961
(989) 773-1968
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
6401006136
MI
103T00000X
Psychologist
6301011699
MI
1041C0700X
Clinical Social Worker
6801084856
MI
2084P0800X
Psychiatry Physician
Primary
5101010873
MI
225XM0800X
Mental Health Occupational Therapist
—
—
251S00000X
Community/Behavioral Health Agency
—
MI
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
4704196395
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1009798
MCLAREN HEALTH PLAN
MI
05
—
214344340
—
MI
01
—
750910703
BLUE CROSS/BLUE SHIELD
MI
05
—
774352754
—
MI
Enumeration date
06/29/2006
Last updated
04/21/2023
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