Mackenzie Michael Crandall, LLPC, MA, TLLP

Primary specialty

CounselorTaxonomy code 101Y00000X

License

6451022802 Issued in MI

Practice address

5980 S Main St Ste 101
Clarkston, MI 48346-2377

Phone

(248) 625-2970

NPI assigned

Feb 20, 2023

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Kindmind Behavioral Health

  • Mental Health Counselor
  • Clarkston, MI
  • NPI 1730897711
  Medicare reassignment NPD
• Kindmind Psychiatric Health

  • Psychiatry Physician
  • Clarkston, MI
  • NPI 1093409666
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1676851200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687132800000",
    "number": "1003514019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2375 WALTON BLVD UNIT 4",
            "city": "ROCHESTER HILLS",
            "state": "MI",
            "postal_code": "483091459",
            "telephone_number": "248-200-8023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5980 S MAIN ST STE 101",
            "city": "CLARKSTON",
            "state": "MI",
            "postal_code": "483462377",
            "telephone_number": "248-625-2970"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRANDALL",
        "first_name": "MACKENZIE",
        "middle_name": "MICHAEL",
        "credential": "LLPC, MA, TLLP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-02-20",
        "last_updated": "2023-06-19",
        "certification_date": "2023-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "MI",
            "license": "6451022802",
            "primary": true
        },
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "MI",
            "license": "6362009701",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Courage and Care Counseling
• Allison Couzens
• Cowan Chiropractic Clinic, P.C.
• John Stephen Cowan, DC
• Savannah Margaret Cox
• Cynthia Ann Crandell, R.N., C.N.
• Jace Alexander Crouch, BEHAVIOR TECHNICIAN
• Sigrid Crowel, MS, LLP
• Leslie J Cruikshank, PT
• Jesus Cruz-Navarro, LLMSW

• Counselor in Clarkston, MI
• Providers in Clarkston, MI by specialty
• Counselor in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.