Healthcare Provider Details

I. General information

NPI: 1952357410
Provider Name (Legal Business Name): BARRY COUNTY COMMUNITY MENTAL HEALTH AUTHORITY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/26/2006
Last Update Date: 07/23/2024
Certification Date: 07/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 BARFIELD DR
HASTINGS MI
49058-9018
US

IV. Provider business mailing address

500 BARFIELD DR
HASTINGS MI
49058-9018
US

V. Phone/Fax

Practice location:
  • Phone: 269-948-8041
  • Fax: 269-948-9319
Mailing address:
  • Phone: 269-948-8041
  • Fax: 269-948-9319

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number080015
License Number StateMI
# 3
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code103TB0200X
TaxonomyCognitive & Behavioral Psychologist
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. RICH THIEMKEY
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 269-948-8041