NPIMap

Organization Active NPI

Clementine Counseling

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Shelby TWP, MI
National Provider Identifier
1265360739
Registry record updated May 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
CLEMENTINE COUNSELING
Practice address
47818 Van Dyke Ave
Shelby TWP, MI 48317-3373
Phone
(586) 323-3620
NPI assigned
May 13, 2026
Last updated
May 13, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 13, 2026

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

Authorized official

Name
Jasmine Koussa, LPCNPI 1710748017
Title
Owner
Phone
(586) 741-9594

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X NU Primary

Addresses

Primary practice location

47818 Van Dyke Ave
Shelby TWP, MI 48317-3373

Mailing address

1515 Hoffman Ave
Royal Oak, MI 48067-3426

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 32

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 32

NPI Registry JSON

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

{
    "created_epoch": "1778630400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1778630400000",
    "number": "1265360739",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1515 HOFFMAN AVE",
            "city": "ROYAL OAK",
            "state": "MI",
            "postal_code": "480673426"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "47818 VAN DYKE AVE",
            "city": "SHELBY TWP",
            "state": "MI",
            "postal_code": "483173373",
            "telephone_number": "586-323-3620"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLEMENTINE COUNSELING",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-05-13",
        "last_updated": "2026-05-13",
        "certification_date": "2026-05-13",
        "status": "A",
        "authorized_official_last_name": "KOUSSA",
        "authorized_official_first_name": "JASMINE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "586-741-9594",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shelby TWP, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2026; 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.