NPIMap

Organization Active NPI

Pastoral Counseling and Consultation Service

Doing business as Dearborn Pastoral Counseling Center

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Dearborn, MI
National Provider Identifier
1124146451
Registry record updated Feb 5, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
PASTORAL COUNSELING AND CONSULTATION SERVICE
Doing business as
Dearborn Pastoral Counseling Center
Practice address
24110 Cherry Hill Rd
Dearborn, MI 48124
Phone
(313) 274-4510
Fax
(313) 274-4571
NPI assigned
Mar 26, 2007
Last updated
Feb 5, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2018

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

Authorized official

Name
Mr. Robert K Seymour, REV. DR.
Title
Executive Director
Phone
(313) 274-4570

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary

Addresses

Primary practice location

24110 Cherry Hill Rd
Dearborn, MI 48124

Mailing address

24110 Cherry Hill Rd
Dearborn, MI 48124
Phone (313) 274-4510

Other names 1

  • Dearborn Pastoral Counseling Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20101020000754 MI Part B Supplier - Clinic/Group Practice 4789877978 Receives reassigned benefits from 6 practitioners
Practice locations: Dearborn, MI

National Provider Directory

National Provider Directory

Locations

24110 Cherry Hill St
Dearborn, MI 48124
Phone (313) 274-4510

Practitioners & affiliated clinicians

Practitioners 11

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1174867200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1517788800000",
    "number": "1124146451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24110 CHERRY HILL RD",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "48124",
            "telephone_number": "313-274-4510",
            "fax_number": "313-274-4571"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24110 CHERRY HILL RD",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "48124",
            "telephone_number": "313-274-4510",
            "fax_number": "313-274-4571"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PASTORAL COUNSELING AND CONSULTATION SERVICE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-26",
        "last_updated": "2018-02-05",
        "status": "A",
        "authorized_official_last_name": "SEYMOUR",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "313-274-4570",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "REV. DR."
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dearborn Pastoral Counseling Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Dearborn, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2018; 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.