Individual provider Active NPI

Colleen Crossey, LMSW

  • Social Worker
  • Novi, MI
National Provider Identifier
1235864273
Registry record updated Oct 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
6801066220 Issued in MI
Practice address
22279 Brockshire St
Novi, MI 48375-4790
Phone
(734) 717-8389
NPI assigned
Jul 22, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 1, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 6801066220 MI Primary

Addresses

Primary practice location

22279 Brockshire St
Novi, MI 48375-4790

Mailing address

22279 Brockshire St
Novi, MI 48375-4790
Phone (734) 717-8389

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230629002548 MI Practitioner - Clinical Social Worker 2769841378 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6801066220MIMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Downriver Mental Health Clinic PC CurrentSince Jun 27, 2023 Accepting new patients
Downriver Mental Health Clinic PC Mental Health CurrentSince Jun 27, 2023 Accepting new patients

Locations

1400 Abbot Rd
Ste 400
East Lansing, MI 48823
Phone (810) 220-2787

44725 Grand River Ave
Ste 104
Novi, MI 48375
Phone (248) 846-8345

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1658448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727740800000",
    "number": "1235864273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22279 BROCKSHIRE ST",
            "city": "NOVI",
            "state": "MI",
            "postal_code": "483754790",
            "telephone_number": "734-717-8389"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22279 BROCKSHIRE ST",
            "city": "NOVI",
            "state": "MI",
            "postal_code": "483754790",
            "telephone_number": "734-717-8389"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CROSSEY",
        "first_name": "COLLEEN",
        "name_prefix": "Ms.",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-07-22",
        "last_updated": "2024-10-01",
        "certification_date": "2024-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MI",
            "license": "6801066220",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Novi, MI

Sources for this page

Verify at the official NPI Registry.