NPIMap

Organization Active NPI

Trinity Lutheran Church

Doing business as Trinity Christian Counseling

  • Counselor
  • Mount Clemens, MI
National Provider Identifier
1033568456
Registry record updated Mar 20, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
6401011168 Issued in MI
Legal business name
TRINITY LUTHERAN CHURCH
Doing business as
Trinity Christian Counseling
Practice address
117 Cass Ave
Suites 300 and 309
Mount Clemens, MI 48043-2252
Phone
(586) 468-0401
NPI assigned
Jun 7, 2016
Last updated
Mar 20, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2017

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

Authorized official

Name
David BrownNPI 1235536152
Title
Director
Phone
(586) 463-2921

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X 6401011168 MI Primary

Addresses

Primary practice location

117 Cass Ave
Suites 300 and 309
Mount Clemens, MI 48043-2252

Mailing address

38900 Harper Ave
Clinton Township, MI 48036-3222
Phone (586) 463-2921

Other names 1

  • Trinity Christian Counseling Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210302001807 MI Part B Supplier - Clinic/Group Practice 6709292592 Receives reassigned benefits from 3 practitioners
Practice locations: Clinton Township, MI

National Provider Directory

National Provider Directory

Locations

38900 Harper Ave
Clinton Township, MI 48036
Phone (586) 463-2921

117 Cass Ave
Ste 300
Mount Clemens, MI 48043
Phone (586) 260-4730

117 Cass Ave
Ste 309
Mount Clemens, MI 48043
Phone (586) 463-2921

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1465257600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1489968000000",
    "number": "1033568456",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "38900 HARPER AVE",
            "city": "CLINTON TOWNSHIP",
            "state": "MI",
            "postal_code": "480363222",
            "telephone_number": "586-463-2921",
            "fax_number": "586-463-2389"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "117 CASS AVE",
            "address_2": "SUITES 300 AND 309",
            "city": "MOUNT CLEMENS",
            "state": "MI",
            "postal_code": "480432252",
            "telephone_number": "586-468-0401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRINITY LUTHERAN CHURCH",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-07",
        "last_updated": "2017-03-20",
        "status": "A",
        "authorized_official_last_name": "BROWN",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "586-463-2921"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "MI",
            "license": "6401011168",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Trinity Christian Counseling",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mount Clemens, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.