Active NPI
Ross Lyle Flynn, PHD, LPC, LMFT, NCC
- Marriage & Family Therapist
- Rochester, MI
National Provider Identifier
1003901000
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 4101006255
- Practice address
- 71 Walnut Blvd
Suite 109
Rochester, MI 48307-2073 - Phone
- (586) 242-5512
- NPI assigned
- Oct 4, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 6401007374 | MI | |
| Marriage & Family Therapist | 106H00000X | 4101006255 | MI | Primary |
Addresses
Primary practice location
71 Walnut Blvd
Suite 109
Rochester, MI 48307-2073
Mailing address
71 Walnut Blvd
Suite 109
Rochester, MI 48307-2073
Phone (586) 242-5512
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6401007374 | MI | MD | Mental Health Counselor |
| 4101006255 | MI | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159920000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1340064000000",
"number": "1003901000",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "71 WALNUT BLVD",
"address_2": "SUITE 109",
"city": "ROCHESTER",
"state": "MI",
"postal_code": "483072073",
"telephone_number": "586-242-5512"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "71 WALNUT BLVD",
"address_2": "SUITE 109",
"city": "ROCHESTER",
"state": "MI",
"postal_code": "483072073",
"telephone_number": "586-242-5512"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FLYNN",
"first_name": "ROSS",
"middle_name": "LYLE",
"name_prefix": "Dr.",
"credential": "PHD, LPC, LMFT, NCC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-10-04",
"last_updated": "2012-06-19",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "MI",
"license": "6401007374",
"primary": false
},
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "MI",
"license": "4101006255",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rochester, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.