Organization Active NPI

Michigan Counseling Collaborative

  • Professional Counselor
  • Waterford, MI
National Provider Identifier
1346089539
Registry record updated Aug 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
Legal business name
MICHIGAN COUNSELING COLLABORATIVE
Practice address
5826 Dixie Hwy
Waterford, MI 48329-1525
Phone
(947) 999-7055
NPI assigned
May 20, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2024

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

Authorized official

Name
Dana Wright, LPCNPI 1568834422
Title
LPC
Phone
(947) 999-7055

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
Professional CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YP2500X Primary

Addresses

Primary practice location

5826 Dixie Hwy
Waterford, MI 48329-1525

Mailing address

5826 Dixie Hwy
Waterford, MI 48329-1525
Phone (947) 999-7055

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20241017001298 MI Part B Supplier - Clinic/Group Practice 2961934708 Receives reassigned benefits from 2 practitioners
Practice locations: Waterford, MI

National Provider Directory

National Provider Directory

Locations

5826 Dixie Hwy
Waterford Township, MI 48329
Phone (248) 383-8770

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1716163200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1724198400000",
    "number": "1346089539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5826 DIXIE HWY",
            "city": "WATERFORD",
            "state": "MI",
            "postal_code": "483291525",
            "telephone_number": "947-999-7055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5826 DIXIE HWY",
            "city": "WATERFORD",
            "state": "MI",
            "postal_code": "483291525",
            "telephone_number": "947-999-7055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHIGAN COUNSELING COLLABORATIVE",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-05-20",
        "last_updated": "2024-08-21",
        "certification_date": "2024-08-21",
        "status": "A",
        "authorized_official_last_name": "WRIGHT",
        "authorized_official_first_name": "DANA",
        "authorized_official_title_or_position": "LPC",
        "authorized_official_telephone_number": "947-999-7055",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waterford, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2024; 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.