MEDICARE: ASCENSION SOUTHEAST MICHIGAN COMMUNITY HEALTH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QM0855X	Adolescent and Children Mental Health Clinic/Center	6401013184	MI

General Provider Information

NPI Number	:	1609245216
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ASCENSION SOUTHEAST MICHIGAN COMMUNITY HEALTH

Provider Business Mailing Address
First Line	:	11600 E 7 MILE RD
Second Line	:
City	:	DETROIT
State	:	MI
Zip	:	48205-2112
Country	:	US
Telephone Number	:	313-373-5974
Fax Number	:	313-372-6579

Provider Business Practice Location Address
First Line	:	11600 E 7 MILE RD
Second Line	:
City	:	DETROIT
State	:	MI
Zip	:	48205-2112
Country	:	US
Telephone Number	:	313-373-5974
Fax Number	:	313-372-6579

Authorized Official
Title or Position	:	BEHAVIORAL HEALLTH COUNSELOR
Name	:	LONNIE FREDERICK HARVEY III
Credential	:	MA, LLPC
Telephone Number	:	313-372-5974

Provider Enumeration Date	:	09/24/2015
Last Update Date	:	05/31/2019

Similar Medicare Providers

1851547038 — MARIE SHOULDERS-WILLIAMS FNP
Practice Location Address:

11600 E 7 MILE RD
DETROIT, MI
48205-2112

Practice Phone: 313-372-5974
Practice Fax:

1902279466 — ST. JOHN PROVIDENCE COMMUNITY HEALTH
Practice Location Address:

11600 E 7 MILE RD
DETROIT, MI
48205-2112

Practice Phone: 313-372-5974
Practice Fax:

1578714903 — MRS. ROBIN ANNETTE JOHNSON-HENDERSON BSW
Practice Location Address:

13340 E WARREN AVE
DETROIT, MI
48215-2112

Practice Phone: 313-822-6940
Practice Fax: 313-822-0176

1508729070 — DANISHA ARTIS
Practice Location Address:

408 N DETROIT ST
BELLEFONTAINE, OH
43311-2112

Practice Phone: 937-441-7614
Practice Fax:

1710097019 — MS. CONNIE L MITCHELL MD
Practice Location Address:

5525 GREENWAY ST , UNIT B-2
DETROIT, MI
48204-2112

Practice Phone: 313-701-1187
Practice Fax: 313-931-9113

1255410023 — POSITIVE IMAGES
Practice Location Address:

13340 E WARREN AVE
DETROIT, MI
48215-2112

Practice Phone: 313-822-6940
Practice Fax: 313-822-6946

Directions to “ASCENSION SOUTHEAST MICHIGAN COMMUNITY HEALTH ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2025 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.