NORTHERN LAKES COMMUNITY MENTAL HEALTH AUTHORITY
NPI 1417481136
Clinic/Center in Traverse City, MI
About Northern Lakes Community Mental Health Authority NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
NORTHERN LAKES COMMUNITY MENTAL HEALTH AUTHORITY (NPI 1417481136), doing business as Northern Lakes Integrated Health Clinic, is a healthcare organization registered as a clinic/center in Traverse City, Michigan and active in the NPI registry since April 2017. The organization lists Erica Longstreet, Chief Clinical Officer, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Names 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Northern Lakes Community Mental Health Authority is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to Northern Lakes Community Mental Health Authority, which bills Medicare for the services this clinician delivers.
Clinician (1)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Northern Lakes Community Mental Health Authority's NPI number?
The NPI number for Northern Lakes Community Mental Health Authority is 1417481136. It was assigned to this organization in the NPPES registry on April 19, 2017. The provider is doing business as Northern Lakes Integrated Health Clinic.
Where is Northern Lakes Community Mental Health Authority located?
Northern Lakes Community Mental Health Authority is located at 105 Hall St Suite C, Traverse City, MI 49684. The listed phone number is (231) 935-3062.
What is Northern Lakes Community Mental Health Authority's specialty?
The primary specialty registered for this NPI is Clinic/Center with taxonomy code 261Q00000X.
Is Northern Lakes Community Mental Health Authority enrolled in Medicare?
Yes. Northern Lakes Community Mental Health Authority is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Northern Lakes Community Mental Health Authority?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Nurse Practitioner) reassigns their Medicare billing to Northern Lakes Community Mental Health Authority. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
What insurance does Northern Lakes Community Mental Health Authority accept?
Health plans from Ambetter Health, Ambetter from Buckeye Health Plan and Ambetter from Meridian list Northern Lakes Community Mental Health Authority as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Northern Lakes Community Mental Health Authority was last updated on August 7, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Northern Lakes Community Mental Health Authority · NPI 1417481136
Clinic/Center organization in Traverse City, Michigan. Organization record, active in the CMS NPPES registry since April 19, 2017.
## Identity
- **NPI:** 1417481136 (Entity type: Organization)
- **Enumerated:** April 19, 2017
- **Primary specialty:** Clinic/Center · taxonomy 261Q00000X
- **Also known as:** Northern Lakes Integrated Health Clinic (Doing Business As)
- **Organization subpart:** Yes (part of Northern Lakes Community Mental Health Authority)
- **Authorized official:** Erica Longstreet, CHIEF CLINICAL OFFICER
## Practice location
- **Address:** 105 HALL ST, SUITE C, Traverse City, MI 49684-2288
- **Phone:** (231) 935-3062
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 1 clinician (Nurse Practitioner) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** August 7, 2026
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Source: [NPI Profile](https://npiprofile.com/npi/1417481136) · Data from the CMS NPPES public registry.