Organization Active NPI

Crossroads of Muskegon , LLC

  • Professional Counselor
  • Muskegon, MI
National Provider Identifier
1043469307
Registry record updated Oct 1, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
4301082875 Issued in MI
Legal business name
CROSSROADS OF MUSKEGON , LLC
Practice address
1541 Peck St
Muskegon, MI 49441-2127
Phone
(231) 747-7530
Fax
(231) 747-7531
NPI assigned
Sep 11, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2008

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

Authorized official

Name
Dr. Nancy Claire Devine, MD
Title
Psychiatrist
Phone
(231) 670-5538

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YP2500X 4301082875 MI Primary

Addresses

Primary practice location

1541 Peck St
Muskegon, MI 49441-2127

Mailing address

1541 Peck St
Muskegon, MI 49441-2127
Phone (231) 747-7530

National Provider Directory

National Provider Directory

Locations

2272 E Apple Ave
Muskegon, MI 49442
Phone (231) 728-4797

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1221091200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1222819200000",
    "number": "1043469307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1541 PECK ST",
            "city": "MUSKEGON",
            "state": "MI",
            "postal_code": "494412127",
            "telephone_number": "231-747-7530",
            "fax_number": "231-747-7531"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1541 PECK ST",
            "city": "MUSKEGON",
            "state": "MI",
            "postal_code": "494412127",
            "telephone_number": "231-747-7530",
            "fax_number": "231-747-7531"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CROSSROADS OF MUSKEGON , LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-11",
        "last_updated": "2008-10-01",
        "status": "A",
        "authorized_official_last_name": "DEVINE",
        "authorized_official_first_name": "NANCY",
        "authorized_official_middle_name": "CLAIRE",
        "authorized_official_title_or_position": "PSYCHIATRIST",
        "authorized_official_telephone_number": "231-670-5538",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "state": "MI",
            "license": "4301082875",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Muskegon, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.