NPIMap

Organization Active NPI

Christian Counseling Center of Battle Creek Inc

  • Clinical Psychologist
  • Battle Creek, MI
National Provider Identifier
1114166907
Registry record updated Aug 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
6301007059 Issued in MI
Legal business name
CHRISTIAN COUNSELING CENTER OF BATTLE CREEK INC
Practice address
601 S Shore Dr Unit 224
Battle Creek, MI 49014-5440
Phone
(269) 979-8119
Fax
(269) 979-8124
NPI assigned
Feb 18, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2023

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

Authorized official

Name
Kim Read, LPC
Title
President
Phone
(269) 979-8119

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 103TC0700X 6301007059 MI Primary

Addresses

Primary practice location

601 S Shore Dr Unit 224
Battle Creek, MI 49014-5440

Mailing address

601 S Shore Dr Unit 224
Battle Creek, MI 49014-5440
Phone (269) 979-8119

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120404000616 MI Part B Supplier - Clinic/Group Practice 3870753528 Receives reassigned benefits from 10 practitioners
Practice locations: Battle Creek, MI

National Provider Directory

National Provider Directory

Locations

601 S Shore Dr
Unit 224
Battle Creek, MI 49014
Phone (269) 969-6115

Practitioners & affiliated clinicians

Practitioners 10

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": "1234915200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1692576000000",
    "number": "1114166907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 S SHORE DR UNIT 224",
            "city": "BATTLE CREEK",
            "state": "MI",
            "postal_code": "490145440",
            "telephone_number": "269-979-8119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 S SHORE DR UNIT 224",
            "city": "BATTLE CREEK",
            "state": "MI",
            "postal_code": "490145440",
            "telephone_number": "269-979-8119",
            "fax_number": "269-979-8124"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHRISTIAN COUNSELING CENTER OF BATTLE CREEK INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-02-18",
        "last_updated": "2023-08-21",
        "certification_date": "2023-08-21",
        "status": "A",
        "authorized_official_last_name": "READ",
        "authorized_official_first_name": "KIM",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "269-979-8119",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6301007059",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Battle Creek, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2023; 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.