Julie Gordon

Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · Croswell, MI

NPI 1194908699 · NPPES record last updated Dec 7, 2007

Key facts

NPI
1194908699
Entity type
Individual (NPI type 1)
Primary specialty
Addiction (Substance Use Disorder) Counselor 101YA0400X
Practice address
4270 Brown Rd
Croswell, MI 48422-9499
Phone
(810) 705-0479
NPI assigned
Dec 7, 2007
Sex
Female
Sole proprietor
No

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 and National Provider Directory roles.

Medicare Care Compare profile

Specialty
Mental Health Counselor
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Blue Water Mental Health Clinic (23 clinicians)

Practice addresses (Care Compare)

1501 Krafft Rd
Fort Gratiot, MI 48059-3565
Phone (810) 985-5125

Medicare participation

Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20241105000226 MI Practitioner - Mental Health Counselor 7810420494 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes

Practice roles

OrganizationSpecialtyStatusNew patients
Blue Water Mental Health Clinic Current
since Sep 26, 2024
Accepting new patients
NPI 1891833810 Current
since Sep 26, 2024
Accepting new patients

Locations

1501 Krafft Rd
Fort Gratiot, MI 48059
Phone (810) 985-5125

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X Yes

Addresses

Primary practice location

4270 Brown Rd
Croswell, MI 48422-9499

Mailing address

4270 Brown Rd
Croswell, MI 48422-9499
Phone (810) 705-0479

Other providers in Croswell, MI

All providers in Croswell, MI · Addiction (Substance Use Disorder) Counselor in Michigan

Sources for this page

Verify at the official NPI Registry.