Nicholas Nathan Serocki, CGC

Primary specialty

Genetic Counselor (M.S.)Taxonomy code 170300000X

License

7201000086 Issued in MI

Practice address

18101 Oakwood Blvd Ste 204
Dearborn, MI 48124-4089

Phone

(313) 436-2083

NPI assigned

Sep 20, 2021

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: nserocki1501829@direct.beaumont.edu

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

{
    "created_epoch": "1632096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760486400000",
    "number": "1053081141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26901 BEAUMONT BLVD STE 3D",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480333849",
            "telephone_number": "947-522-1865"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18101 OAKWOOD BLVD STE 204",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481244089",
            "telephone_number": "313-436-2083"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEROCKI",
        "first_name": "NICHOLAS",
        "middle_name": "NATHAN",
        "credential": "CGC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-09-20",
        "last_updated": "2025-10-15",
        "certification_date": "2025-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "170300000X",
            "taxonomy_group": "",
            "desc": "Genetic Counselor, MS",
            "state": "MI",
            "license": "7201000086",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "nserocki1501829@direct.beaumont.edu",
            "affiliation": "N",
            "address_1": "18101 Oakwood Blvd Ste 204",
            "city": "Dearborn",
            "state": "MI",
            "country_code": "US",
            "postal_code": "481244089",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Genetic Counselor (M.S.) in Dearborn, MI
• Providers in Dearborn, MI by specialty
• Genetic Counselor (M.S.) in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2025; 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.