Starboard Counseling LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

STARBOARD COUNSELING LLC

Practice address

3923 Essex PL
Fort Gratiot, MI 48059-3762

Phone

(406) 480-6070

NPI assigned

Oct 19, 2023

Organization subpart

No

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

Authorized official

Name

Christopher Douglas Mullin, LMSWNPI 1336328442

Title

Sole Member

Phone

(406) 480-6070

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Christopher Douglas Mullin, LMSW

  • Clinical Social Worker
  • Port Huron, MI
  • NPI 1336328442
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1697673600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1697673600000",
    "number": "1134901481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3923 ESSEX PL",
            "city": "FORT GRATIOT",
            "state": "MI",
            "postal_code": "480593762",
            "telephone_number": "406-480-6070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3923 ESSEX PL",
            "city": "FORT GRATIOT",
            "state": "MI",
            "postal_code": "480593762",
            "telephone_number": "406-480-6070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STARBOARD COUNSELING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-10-19",
        "last_updated": "2023-10-19",
        "certification_date": "2023-10-19",
        "status": "A",
        "authorized_official_last_name": "MULLIN",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_middle_name": "DOUGLAS",
        "authorized_official_title_or_position": "SOLE MEMBER",
        "authorized_official_telephone_number": "406-480-6070",
        "authorized_official_credential": "LMSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christine A Spoutz
• Selena Nicole Squires
• Sarah Elizabeth St. Coeur, M.A., CCC-SLP/L
• Nicole Maire St.Louis
• Angie M Stabile
• Danielle Stark
• Heather Louise Stencel
• Alaina Lyn Stephens
• Julie A Stevenson, PT
• Jude L Stratford, D.O.

• Clinical Social Worker in Fort Gratiot, MI
• Providers in Fort Gratiot, MI by specialty
• Clinical Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 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.