Active NPI
Bridgette Crockett, MA LPC
- Professional Counselor
- Ferndale, MI
National Provider Identifier
1164968814
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 6401017079
- Practice address
- 3178 Hilton Rd
Ferndale, MI 48220 - Phone
- (483) 312-7442
- NPI assigned
- Jan 18, 2017
- Last updated
- Nov 13, 2019
- 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 | 6401017079 | MI | Primary |
Addresses
Primary practice location
3178 Hilton Rd
Ferndale, MI 48220
Mailing address
3178 Hilton Rd
Ferndale, MI 48220-1059
Phone (483) 312-7442
Other practice location 1
44899 Centre Ct
Clinton Township, MI 48038-5510
Phone (586) 690-8331 ext. 108
Other practice location 2
3178 Hilton Rd
Ferndale, MI 48220
Phone (483) 312-7442 ext. 108
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
- Credentials
- Master of Arts
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lifelab Kids Foundation | Mental Health | Current | Accepting new patients |
Locations
3178 Hilton Rd
Ferndale, MI 48220
Phone (248) 331-2744
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": "1484697600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1573603200000",
"number": "1164968814",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3178 HILTON RD",
"city": "FERNDALE",
"state": "MI",
"postal_code": "482201059",
"telephone_number": "483-312-7442"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3178 HILTON RD",
"city": "FERNDALE",
"state": "MI",
"postal_code": "48220",
"telephone_number": "483-312-7442"
}
],
"practiceLocations": [
{
"address_1": "44899 Centre Ct",
"address_purpose": "LOCATION",
"city": "Clinton Township",
"state": "MI",
"postal_code": "480385510",
"country_code": "US",
"telephone_number": "586-690-8331 x108",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "3178 Hilton Rd",
"address_purpose": "LOCATION",
"city": "Ferndale",
"state": "MI",
"postal_code": "48220",
"country_code": "US",
"telephone_number": "483-312-7442 x108",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "CROCKETT",
"first_name": "BRIDGETTE",
"credential": "MA LPC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-01-18",
"last_updated": "2019-11-13",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "MI",
"license": "6401017079",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ferndale, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.