NPIMap

Organization Active NPI

Alex E. Costinew PH.D.,P.C.

Doing business as Counseling and Development Clinic

  • Psychologist
  • Farmington Hills, MI
National Provider Identifier
1093820938
Registry record updated Oct 4, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
6301002052 Issued in MI
Legal business name
ALEX E. COSTINEW PH.D.,P.C.
Doing business as
Counseling and Development Clinic
Practice address
38345 W 10 Mile Rd
Ste 150-a
Farmington Hills, MI 48335-2867
Phone
(810) 588-9204
Fax
(248) 987-2824
NPI assigned
Aug 20, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2010

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

Authorized official

Name
Dr. Alex E Costinew, PH.D.NPI 1962637413
Title
Owner and Director
Phone
(810) 588-9204

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Professional CounselorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 101YP2500X 6401006534 MI
PsychologistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 103T00000X 6301002052 MI Primary
Clinical Social WorkerGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1041C0700X 6801017579 MI

Addresses

Primary practice location

38345 W 10 Mile Rd
Ste 150-a
Farmington Hills, MI 48335-2867

Mailing address

38345 W 10 Mile Rd
Ste 150-a
Farmington Hills, MI 48335-2867
Phone (810) 588-9204

Other identifiers 1

IdentifierTypeStateIssuer
0F34734OtherMIBCBS OF MI PIN

Other names 1

  • Counseling and Development Clinic Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110908002065 MI Part B Supplier - Clinic/Group Practice 0547430175 Receives reassigned benefits from 1 practitioner
Practice locations: Pinckney, MI

National Provider Directory

National Provider Directory

Locations

38345 W 10 Mile Rd
Ste 150A
Farmington Hills, MI 48335
Phone (810) 588-9204

31700 W 13 Mile Rd
Ste 201
Farmington Hills, MI 48334
Phone (810) 588-9204

Practitioners & affiliated clinicians

Practitioners 2

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": "1156032000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1286150400000",
    "number": "1093820938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "38345 W 10 MILE RD",
            "address_2": "STE 150-A",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483352867",
            "telephone_number": "810-588-9204",
            "fax_number": "248-987-2824"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "38345 W 10 MILE RD",
            "address_2": "STE 150-A",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483352867",
            "telephone_number": "810-588-9204",
            "fax_number": "248-987-2824"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALEX E. COSTINEW PH.D.,P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-20",
        "last_updated": "2010-10-04",
        "status": "A",
        "authorized_official_last_name": "COSTINEW",
        "authorized_official_first_name": "ALEX",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OWNER AND DIRECTOR",
        "authorized_official_telephone_number": "810-588-9204",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": "MI",
            "license": "6401006534",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": "MI",
            "license": "6301002052",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801017579",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF MI PIN",
            "identifier": "0F34734",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Counseling and Development Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Farmington Hills, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.