NPIMap

Individual provider Active NPI

Margaret Ann Costello, MA, JD, LLP

  • Psychologist
  • Livonia, MI
National Provider Identifier
1164854220
Registry record updated Jul 31, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
6301002741 Issued in MI
Practice address
17177 North Laurel Park; Suite 131
Cruz Clinic
Livonia, MI 48152
Phone
(734) 462-3210
NPI assigned
Jul 31, 2013
Last updated
Jul 31, 2013By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 31, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 6301002741 MI Primary

Addresses

Primary practice location

17177 North Laurel Park; Suite 131
Cruz Clinic
Livonia, MI 48152

Mailing address

15601 Essex Ave
Grosse Pointe Park, MI 48230-1720
Phone (313) 596-9854

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)
Not enrolled
Credentials
Juris Doctor, Master of Arts

State licenses

LicenseStateTypeSpecialty
6301002741MIMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Victor M. Cruz MD, P.C. Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1375228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1375228800000",
    "number": "1164854220",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15601 ESSEX AVE",
            "city": "GROSSE POINTE PARK",
            "state": "MI",
            "postal_code": "482301720",
            "telephone_number": "313-596-9854",
            "fax_number": "313-596-9825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17177 NORTH LAUREL PARK; SUITE 131",
            "address_2": "CRUZ CLINIC",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "48152",
            "telephone_number": "734-462-3210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COSTELLO",
        "first_name": "MARGARET",
        "middle_name": "ANN",
        "name_prefix": "Prof.",
        "credential": "MA, JD, LLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-07-31",
        "last_updated": "2013-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MI",
            "license": "6301002741",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Livonia, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.