Organization Active NPI

Professional Outreach Counseling Services PC

  • Psychologist
  • Wayne, MI
National Provider Identifier
1295898385
Registry record updated Jun 16, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
6301009925 Issued in MI
Legal business name
PROFESSIONAL OUTREACH COUNSELING SERVICES PC
Practice address
34841 Veterans PLZ
Wayne, MI 48184-1733
Phone
(313) 292-7640
Fax
(313) 292-9270
NPI assigned
Dec 19, 2006
Last updated
Jun 16, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2014

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

Authorized official

Name
Colin F. King, PHD. LP.NPI 1144344417
Title
Owner
Phone
(313) 292-7640

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 14

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YA0400X 6801077910 MI
Addiction (Substance Use Disorder) CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YA0400X 6401008900 MI
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X 6401007447 MI
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X 6401009679 MI
Professional CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YP2500X 6401008194 MI
Professional CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YP2500X 6401009106 MI
PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103T00000X 6301009054 MI
PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103T00000X 6301009925 MI Primary
Clinical PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC0700X 009925 MI
School PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TS0200X 6301010278 MI
Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 104100000X 6801083794 MI
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X 6801064655 MI
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X 6801063516 MI
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X 2901019243 MI

Addresses

Primary practice location

34841 Veterans PLZ
Wayne, MI 48184-1733

Mailing address

34841 Veterans PLZ
Wayne, MI 48184-1733
Phone (313) 292-7640

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070430000662 MI Part B Supplier - Clinic/Group Practice 9234235771 Receives reassigned benefits from 3 practitioners
Practice locations: Wayne, MI

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1166486400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1402876800000",
    "number": "1295898385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34841 VETERANS PLZ",
            "city": "WAYNE",
            "state": "MI",
            "postal_code": "481841733",
            "telephone_number": "313-292-7640",
            "fax_number": "313-292-9270"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34841 VETERANS PLZ",
            "city": "WAYNE",
            "state": "MI",
            "postal_code": "481841733",
            "telephone_number": "313-292-7640",
            "fax_number": "313-292-9270"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROFESSIONAL OUTREACH COUNSELING SERVICES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-19",
        "last_updated": "2014-06-16",
        "status": "A",
        "authorized_official_last_name": "KING",
        "authorized_official_first_name": "COLIN",
        "authorized_official_middle_name": "F.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "313-292-7640",
        "authorized_official_credential": "PHD. LP."
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MI",
            "license": "6801077910",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MI",
            "license": "6401008900",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "MI",
            "license": "6401007447",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "MI",
            "license": "6401009679",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": "MI",
            "license": "6401008194",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": "MI",
            "license": "6401009106",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": "MI",
            "license": "6301009054",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": "MI",
            "license": "6301009925",
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "009925",
            "primary": false
        },
        {
            "code": "103TS0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, School",
            "state": "MI",
            "license": "6301010278",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker",
            "state": "MI",
            "license": "6801083794",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801064655",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801063516",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901019243",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wayne, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2014; 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.