{"npi":"1447644471","type":"NPI-2","status":"active","name":{"display":"Lakeshore Integrative Mental Health Services, LLC","other":[],"organization_name":"LAKESHORE INTEGRATIVE MENTAL HEALTH SERVICES, LLC","authorised_official":"Diane Bruursema"},"specialty":{"primary_taxonomy":"1041C0700X","primary_taxonomy_description":"Clinical Social Worker","slug":"clinical-social-worker","schema_org_specialty":null,"all":[{"code":"1041C0700X","description":"Clinical Social Worker","primary":true,"state":null,"license":null}]},"addresses":[{"purpose":"LOCATION","street_1":"800 E ELLIS RD","city":"NORTON SHORES","state":"MI","postal_code":"494415646","country_code":"US","street_2":"MAIL BOX 577, SUITE 271","phone":"2317994850","fax":"2317994851"},{"purpose":"MAILING","street_1":"800 E ELLIS RD","city":"NORTON SHORES","state":"MI","postal_code":"494415646","country_code":"US","street_2":"MAIL BOX 577, SUITE 271","phone":"2317994850","fax":"2317994851"}],"license":null,"identifiers":[],"pecos":{"enrolled_at":"2026-05-09T10:41:39.028268+00:00","enrollments":[{"enrlmt_id":"O20180417002105","type_code":"12-70","type_desc":"PART B SUPPLIER - CLINIC/GROUP PRACTICE","state":"MI","pac_id":"8022371491"}]},"enumeration_date":"2015-03-27","last_updated":"2015-03-27","_meta":{"source":"NPPES","snapshot_date":"2015-03-27","doc_url":"https://findmynpi.com/api"}}