ADVANCED MENTAL HEALTH AND TBI SERVICES PLLC — NPI 1255087698 (Licensed & Credentialed Behavioral Health & Social Service Providers

CMS-1500 Box 24J / 33a • NPI

1255087698

Type 2 Organization (Box 32a/33a)

HIPAA NUCC Taxonomy • CMS Code

1041C0700X (CMS 80)

Licensed & Credentialed Behavioral Health & Social Service Providers — Social Worker, Clinical

Box 32 Service Location & ZIP+4

9864 E GRAND RIVER AVE STE 110-131, BRIGHTON, MI, 48116-1963

✓ 9-Digit EDI 837 ZIP+4 (48116-1963)

Practice Phone & Referral Fax

(810) 844-6146

Fax: (248) 282-7022

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1255087698 (ADVANCED MENTAL HEALTH AND TBI SERVICES PLLC) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).

CMS Medicare Order & Referring PECOS Eligibility

Institutional Type-2 NPI facilities enroll via CMS-855A institutional provider agreements rather than individual Order & Referring PECOS.

Official CMS NPPES Credential & Practice Profile

10-Digit NPI Number	`1255087698` (NPI-2 Organization / Facility)
Provider / Legal Name	ADVANCED MENTAL HEALTH AND TBI SERVICES PLLC
Plain-English Specialty	Licensed & Credentialed Behavioral Health & Social Service Providers — Social Worker, Clinical NUCC Code: `1041C0700X` (Social Worker, Clinical)
Certifying / Licensing Body	State Medical / Healthcare Licensing Board & National Specialty Board
Practice Location Address	9864 E GRAND RIVER AVE STE 110-131, BRIGHTON, MI, 48116-1963
Practice Telephone / Fax	Tel: (810) 844-6146 \| Fax: (248) 282-7022
Administrative Mailing Address	1384 SEWARD CT, BRIGHTON, MI, 48116-3790
Enumeration & Last Sync	Enumerated: 2022-02-24 \| CMS Record Updated: 2022-02-24
Authorized Official	DONALD BOOTH (owner)

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

9864 E GRAND RIVER AVE STE 110-131, BRIGHTON, MI, 48116-1963

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Plain-English Taxonomy & CMS Crosswalk (1041C0700X)

What Does Taxonomy Code 1041C0700X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 1041C0700X translates to:
"Licensed & Credentialed Behavioral Health & Social Service Providers — Social Worker, Clinical"

CMS-1500 Medicare Specialty Crosswalk: CMS Code 80 (Licensed Clinical Social Worker)
Certifying / Accrediting Authority: State Medical / Healthcare Licensing Board & National Specialty Board
Clinical Scope: Consult a verified Social Worker, Clinical for specialized diagnostic evaluation, treatment planning, and continuity of care.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (ADVANCED MENTAL HEALTH AND TBI SERVICES PLLC)

Typical CPT / Diagnostic Procedures:

Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
Preventive Screening, Patient Counseling & Multidisciplinary Referral

Common Therapeutic Classes:

Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)

All Registered NUCC Taxonomies & State Licenses

Taxonomy Code & Plain-English Description	State License & Primary Status
`1041C0700X` — Social Worker, Clinical Plain English: Licensed & Credentialed Behavioral Health & Social Service Providers — Social Worker, Clinical	State: N/A \| License: `Verified` \| Primary: Yes (Primary)

Medical Billing, RCM & Hospital Credentialing Teams:

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ADVANCED MENTAL HEALTH AND TBI SERVICES PLLC (NPI #1255087698)