Core Counseling Center LLC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

Legal business name

CORE COUNSELING CENTER LLC

Practice address

1345 Monroe Ave NW Ste 234
Grand Rapids, MI 49505-4692

Phone

(616) 420-1060

NPI assigned

Jun 20, 2018

Organization subpart

No

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

Authorized official

Name

Tierra Youngblood-Field, LPC, LLMFTNPI 1346757762

Title

Professional Counselor

Phone

(616) 420-1060

Specialties & licenses 3

Addresses

Other identifiers 1

Electronic endpoints 1

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.

• Tierra Youngblood-Field

  • Professional Counselor
  • Grand Rapids, MI
  • NPI 1346757762

  Mental Health

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1529452800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1577750400000",
    "number": "1205320561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1345 MONROE AVE NW STE 234",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495054692"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1345 MONROE AVE NW STE 234",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495054692",
            "telephone_number": "616-420-1060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CORE COUNSELING CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-06-20",
        "last_updated": "2019-12-31",
        "certification_date": "2019-12-31",
        "status": "A",
        "authorized_official_last_name": "YOUNGBLOOD-FIELD",
        "authorized_official_first_name": "TIERRA",
        "authorized_official_title_or_position": "PROFESSIONAL COUNSELOR",
        "authorized_official_telephone_number": "616-420-1060",
        "authorized_official_credential": "LPC, LLMFT"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1205320561",
            "state": "MI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tierra@corecounseling-youngblood.com",
            "affiliation": "N",
            "endpointDescription": "Email",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1345 Monroe Ave NW Ste 234",
            "city": "Grand Rapids",
            "state": "MI",
            "country_code": "US",
            "postal_code": "495054692",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Madalyn Dolores Copus, PA
• Ewa Malgorzata Corbett, RPH
• Yolanda Rita Cordele
• Marcos Itamar Cordoba Munoz, M.D.
• Bianca Cordova, OTD, OTRL
• Wendy Corelli, MS, AT., ATC
• Joseph Michael Corey, MD
• Jennifer Coria
• Tabitha Corlett, RN
• Jonathan P Corley, PA-C

• Professional Counselor in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Professional Counselor in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2019; 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.