Active NPI
Christine Simmons, LPC
- Professional Counselor
- Detroit, MI
National Provider Identifier
1124230321
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 6401006604
- Practice address
- 24424 W McNichols Rd
Detroit, MI 48219-3653 - Phone
- (313) 531-2500
- NPI assigned
- May 3, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 6401006604 | MI | Primary |
Addresses
Primary practice location
24424 W McNichols Rd
Detroit, MI 48219-3653
Mailing address
30958 Stone Ridge Dr
Wixom, MI 48393-3869
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6401006604 | MI | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1178150400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1124230321",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "30958 STONE RIDGE DR",
"city": "WIXOM",
"state": "MI",
"postal_code": "483933869"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "24424 W MCNICHOLS RD",
"city": "DETROIT",
"state": "MI",
"postal_code": "482193653",
"telephone_number": "313-531-2500"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SIMMONS",
"first_name": "CHRISTINE",
"credential": "LPC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-05-03",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "MI",
"license": "6401006604",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Detroit, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.