Individual provider Active NPI

Daniel Thomas Bukacel Jr.

  • Mental Health Counselor
  • Clinton TWP, MI
National Provider Identifier
1043895121
Registry record updated Oct 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
6451022246 Issued in MI
Practice address
16645 15 Mile Rd
Clinton TWP, MI 48035-2206
Phone
(586) 213-5505
NPI assigned
Mar 10, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X
Mental Health Counselor 101YM0800X 6451022246 MI Primary

Addresses

Primary practice location

16645 15 Mile Rd
Clinton TWP, MI 48035-2206

Mailing address

16645 15 Mile Rd
Clinton TWP, MI 48035-2206
Phone (586) 213-5505

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20260330000822 MI Practitioner - Mental Health Counselor 2163907072 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2022
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

16645 15 Mile Rd
Clinton Township, MI 48035-2206

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6451022246MIMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
CNS Healthcare PastSince Mar 1, 2021 Accepting new patients
All Things Possible Wellness Center, PLLC Mental Health Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1615334400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666051200000",
    "number": "1043895121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16645 15 MILE RD",
            "city": "CLINTON TWP",
            "state": "MI",
            "postal_code": "480352206",
            "telephone_number": "586-213-5505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16645 15 MILE RD",
            "city": "CLINTON TWP",
            "state": "MI",
            "postal_code": "480352206",
            "telephone_number": "586-213-5505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUKACEL",
        "first_name": "DANIEL",
        "middle_name": "THOMAS",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-03-10",
        "last_updated": "2022-10-18",
        "certification_date": "2022-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MI",
            "license": "6451022246",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clinton TWP, MI

Sources for this page

Verify at the official NPI Registry.