BROOKSIDE PEDIATRIC THERAPY LLC NPI 1467225946

NPI Information

  • NPI: 1467225946
  • Provider Name: BROOKSIDE PEDIATRIC THERAPY LLC
  • Classification: Clinic/Center - 261QM0801X
  • Specialization: Mental Health (Including Community Mental Health Center)
  • Entity Type: Organization
  • Address: 39650 ORCHARD HILL PL
    NOVI, MI
    ZIP 48375
  • Phone: (248) 747-4263

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NPI Details

BROOKSIDE PEDIATRIC THERAPY LLC is a mental health (including community mental health center) clinic center in Novi, MI. BROOKSIDE PEDIATRIC THERAPY LLC NPI is 1467225946. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

39650 ORCHARD HILL PL
NOVI, MI
ZIP 48375-392
Phone: (248) 747-4263

The provider's authorized official is Yasser Mansour .
The authorized official title is Ceo and has the following contact phone number (313) 207-4645.

The enumeration date for this NPI number is 11/6/2023 and was last updated on 10/7/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1103K00000XBehavior AnalystNo
2106E00000XAssistant Behavior AnalystNo
3106S00000XBehavior TechnicianNo
4171M00000XCase Manager/Care CoordinatorNo
5225100000XPhysical TherapistNo
6225200000XPhysical Therapy AssistantNo
7225XM0800XOccupational TherapistMental HealthNo
8225XP0019XOccupational TherapistPhysical RehabilitationNo
9225XP0200XOccupational TherapistPediatricsNo
102355S0801XSpecialist/TechnologistSpeech-Language AssistantNo
11235Z00000XSpeech-Language PathologistNo
12251B00000XCase ManagementNo
13252Y00000XEarly Intervention Provider AgencyNo
14261QM0801XClinic/CenterMental Health (Including Community Mental Health Center)Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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