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 |