Tina Marie Persha, MA LPC CACII

Primary specialty

CounselorTaxonomy code 101Y00000X

License

6401000816 Issued in MI

Practice address

52188 Vandyke
Ste 320
Shelby TWP, MI 48316

Phone

(286) 254-7774

Fax

(586) 254-7766

NPI assigned

Oct 16, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

Practice roles

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.

• Shelby Counseling, Inc.

  • Clinical Psychologist
  • Shelby Township, MI
  • NPI 1144647892
  NPD (past)

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

{
    "created_epoch": "1160956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1225128499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "52188 VANDYKE",
            "address_2": "STE 320",
            "city": "SHELBY TWP",
            "state": "MI",
            "postal_code": "48316",
            "telephone_number": "286-254-7774",
            "fax_number": "586-254-7766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "52188 VANDYKE",
            "address_2": "STE 320",
            "city": "SHELBY TWP",
            "state": "MI",
            "postal_code": "48316",
            "telephone_number": "286-254-7774",
            "fax_number": "586-254-7766"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERSHA",
        "first_name": "TINA",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "MA LPC CACII",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "MI",
            "license": "6401000816",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7969655",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Pediatric Motorwerks Occupational Therapy, LLC
• Pehur Chiropractic Center, PLLC
• Derek William Pehur, D.C.
• Mario Pengili
• Olivia Penzien
• Laura Marie Pettibone
• Pharmascript of Shelby Inc
• Patricia Anne Pich, PH.D., LPC
• Sarah Goswami Piet
• Gregory John Pine, DDS

• Counselor in Shelby TWP, MI
• Providers in Shelby TWP, MI by specialty
• Counselor in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.