Individual provider Active NPI

David Prince, LPC

  • Professional Counselor
  • Traverse City, MI
National Provider Identifier
1063840304
Registry record updated Mar 7, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
6401008775 Issued in MI
Practice address
3301 Veterans Dr
Suite 205
Traverse City, MI 49684-4574
Phone
(231) 342-7890
NPI assigned
Oct 24, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 7, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 6401008775 MI Primary

Addresses

Primary practice location

3301 Veterans Dr
Suite 205
Traverse City, MI 49684-4574

Mailing address

2424 Tyler Hills Dr
Traverse City, MI 49685-7350
Phone (231) 342-7890

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
I20240229003212 MI Practitioner - Mental Health Counselor 6800231820 Practice locations: Traverse City, MI

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
David Prince LPC Professional CurrentSince Aug 6, 2019 Accepting new patients

Organizations & group practices 1

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": "1382572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1394150400000",
    "number": "1063840304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2424 TYLER HILLS DR",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496857350",
            "telephone_number": "231-342-7890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3301 VETERANS DR",
            "address_2": "SUITE 205",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496844574",
            "telephone_number": "231-342-7890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRINCE",
        "first_name": "DAVID",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-10-24",
        "last_updated": "2014-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MI",
            "license": "6401008775",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Traverse City, MI

Sources for this page

Verify at the official NPI Registry.