Individual provider Active NPI

Cynthia Ann Kozak, LPC

  • Counselor
  • Shelby Township, MI
National Provider Identifier
1073713699
Registry record updated Jul 22, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
6401006810 Issued in MI
Practice address
46413 Spruce Dr
Shelby Township, MI 48315-5757
Phone
(586) 991-0639
NPI assigned
Jul 22, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 22, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X 6401006810 MI Primary

Addresses

Primary practice location

46413 Spruce Dr
Shelby Township, MI 48315-5757

Mailing address

PO Box 183445
Shelby Township, MI 48318-3445
Phone (586) 991-0639

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
6401006810MIMDCounselor

NPI Registry JSON

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

{
    "created_epoch": "1185062400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1185062400000",
    "number": "1073713699",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 183445",
            "city": "SHELBY TOWNSHIP",
            "state": "MI",
            "postal_code": "483183445",
            "telephone_number": "586-991-0639"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "46413 SPRUCE DR",
            "city": "SHELBY TOWNSHIP",
            "state": "MI",
            "postal_code": "483155757",
            "telephone_number": "586-991-0639"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOZAK",
        "first_name": "CYNTHIA",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-07-22",
        "last_updated": "2007-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "MI",
            "license": "6401006810",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shelby Township, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2007; 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.