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BY MOONLIGHT AND TIDE PSYCHOTHERAPY PLLC
NPI 1912798174
Clinic/Center - Mental Health (Including Community Mental Health Center) in Okemos, MI

Active since May 15, 2025
2222 W GRAND RIVER AVE STE A, OKEMOS, MI 48864(248) 266-0625 Get Directions Write a Review

NPPES record last updated: May 15, 2025. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About By Moonlight And Tide Psychotherapy Pllc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BY MOONLIGHT AND TIDE PSYCHOTHERAPY PLLC (NPI 1912798174) is a healthcare organization registered as a mental health (including community mental health center) in Okemos, Michigan and active in the NPI registry since May 2025. The organization maintains a secondary practice location in Lake Orion and lists Cassiann M Procenko, Clinical Director, as its authorized official.

NPPES Registry Identity

NPI1912798174
Entity TypeOrganization
Primary Taxonomy261QM0801X
Legal Business NameBY MOONLIGHT AND TIDE PSYCHOTHERAPY PLLC
Location Address2222 W GRAND RIVER AVE STE AOkemos, MI 48864-1604
Mailing Address740 Kimberly Apt 302Lake Orion, MI 48362-2963 · (320) 310-8895
Phone(248) 266-0625
Organization SubpartNo
Authorized OfficialCassiann M ProcenkoClinical Director · (320) 310-8895
Enumeration DateMay 15, 2025
NPPES CertifiedMay 15, 2025
✔ NPI 1912798174 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Mental Health (Including Community Mental Health Center)Ambulatory Health Care Facilities
Taxonomy Code261QM0801X
2222 W GRAND RIVER AVE STE A, Okemos, MI 48864
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Secondary Practice Location 1

Location 1740 Kimberly Apt 302Lake Orion, MI 48362-2963 · Phone (248) 266-0625

Other Providers at the Same Location NPPES 19

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

FOCAL POINT PAIN SOLUTIONS, PLLC
Clinic/Center (Pain)
2222 W GRAND RIVER AVE STE A
OKEMOS, MI 48864
Ingham County (248) 770-3825
AFFINITY COUNSELING LLC
Marriage & Family Therapist
2222 W GRAND RIVER AVE STE A
OKEMOS, MI 48864
Ingham County (989) 265-1354
DR. CATHLEEN M LALONDE PH.D.
Psychologist (Health Service)
2222 W GRAND RIVER AVE STE A
OKEMOS, MI 48864
Ingham County (482) 221-1670
AVANTI WOUND PHYSICIANS, PLLC.
Family Medicine
2222 W GRAND RIVER AVE STE A
OKEMOS, MI 48864
Ingham County (630) 686-2134
BRIDGING GAPS HOME CARE LLC
In Home Supportive Care
2222 W GRAND RIVER AVE STE A
OKEMOS, MI 48864
Ingham County (313) 265-6957
MRS. ALYSSA KLEIN LMSW
Social Worker (Clinical)
2222 W GRAND RIVER AVE STE A
OKEMOS, MI 48864
Ingham County (248) 918-0923
MICHELLE MADISON LMSW/LCSW
Social Worker (Clinical)
2222 W GRAND RIVER AVE STE A
OKEMOS, MI 48864
Ingham County (734) 508-2213
MIDWEST BEHAVIORAL HEALTH TREATMENT CENTER PLLC
Social Worker (Clinical)
2222 W GRAND RIVER AVE STE A
OKEMOS, MI 48864
Ingham County (734) 508-2213

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 By Moonlight And Tide Psychotherapy PLLC's NPI number?

The NPI number for By Moonlight And Tide Psychotherapy PLLC is 1912798174. It was assigned to this organization in the NPPES registry on May 15, 2025.

Where is By Moonlight And Tide Psychotherapy PLLC located?

By Moonlight And Tide Psychotherapy PLLC is located at 2222 W Grand River Ave Ste A, Okemos, MI 48864. The listed phone number is (248) 266-0625.

What is By Moonlight And Tide Psychotherapy PLLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Mental Health (Including Community Mental Health Center), with taxonomy code 261QM0801X.

When was this NPI record last updated?

The NPPES record for By Moonlight And Tide Psychotherapy PLLC was last updated on May 15, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.