Active NPI
Christine Marie Daugherty, RN
- Addiction (Substance Use Disorder) Counselor
- Benton Harbor, MI
National Provider Identifier
1194092734
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- 4704209681
- Practice address
- 1022 E Main St
Benton Harbor, MI 49022-3036 - Phone
- (269) 926-0015
- Fax
- (269) 926-0015
- NPI assigned
- Nov 28, 2011
- 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 |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 4704209681 | MI | Primary |
Addresses
Primary practice location
1022 E Main St
Benton Harbor, MI 49022-3036
Mailing address
1022 E Main St
Benton Harbor, MI 49022-3036
Phone (269) 926-0015
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
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4704209681 | MI | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1322438400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1322438400000",
"number": "1194092734",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1022 E MAIN ST",
"city": "BENTON HARBOR",
"state": "MI",
"postal_code": "490223036",
"telephone_number": "269-926-0015",
"fax_number": "369-926-0015"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1022 E MAIN ST",
"city": "BENTON HARBOR",
"state": "MI",
"postal_code": "490223036",
"telephone_number": "269-926-0015",
"fax_number": "269-926-0015"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAUGHERTY",
"first_name": "CHRISTINE",
"middle_name": "MARIE",
"credential": "RN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-11-28",
"last_updated": "2011-11-28",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "MI",
"license": "4704209681",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Benton Harbor, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.