Christina M Petzel, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

6401009035 Issued in MI

Practice address

500 10TH St
Port Huron, MI 48060-4477

Phone

(800) 395-3223

Fax

(833) 329-6632

NPI assigned

Apr 17, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Specialty

Mental Health Counselor

Education

Other, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ismail B Sendi MD PCGroup PAC ID 4688674534, 72 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Ismail B. Sendi, MD, PC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Clarkston, MI
  • NPI 1609882067
  Medicare reassignment Care Compare group NPD
• Ismail B. Sendi, MD, PC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Clinton Township, MI
  • NPI 1932370988
  NPD
• Comprehensive Youth Services Inc

  • Community/Behavioral Health Agency
  • Mount Clemens, MI
  • NPI 1750400065
  NPD (past)

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

{
    "created_epoch": "1176768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594771200000",
    "number": "1104042548",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6549 TOWN CENTER DR STE A",
            "city": "CLARKSTON",
            "state": "MI",
            "postal_code": "483464824",
            "telephone_number": "800-395-3223",
            "fax_number": "833-329-6632"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 10TH ST",
            "city": "PORT HURON",
            "state": "MI",
            "postal_code": "480604477",
            "telephone_number": "800-395-3223",
            "fax_number": "833-329-6632"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2 Crocker Blvd",
            "address_2": "Suite 101",
            "address_purpose": "LOCATION",
            "city": "Mt Clemens",
            "state": "MI",
            "postal_code": "480432558",
            "country_code": "US",
            "telephone_number": "586-468-2266",
            "fax_number": "586-468-4505",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PETZEL",
        "first_name": "CHRISTINA",
        "middle_name": "M",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-17",
        "last_updated": "2020-07-15",
        "certification_date": "2020-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "MI",
            "license": "6401009035",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MI",
            "license": "6401009035",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Perry Drug Stores Inc and Subsidiaries
• Shawn Perry
• Andrew F Pesta, D.C.
• Jamie Lynn Peterson, BA
• Lacey Pettee
• Nancy A Pfeifer, LBSW
• Alicia Rae Phillips, LLMSW
• Brittney Phillips
• Elizabeth Ann Phillips
• Jill Phillips

• Professional Counselor in Port Huron, MI
• Providers in Port Huron, MI by specialty
• Professional Counselor in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.