Omega C Mostyn, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

6401223696 Issued in MI

Practice address

26522 Van Dyke Ave
Center Line, MI 48015-1221

Phone

(586) 759-4400

NPI assigned

Jun 22, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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 and National Provider Directory roles.

• The Children'S Center of Wayne Co., Inc.

  • Community/Behavioral Health Agency
  • Detroit, MI
  • NPI 1528145844
  NPD (past)

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

{
    "created_epoch": "1624320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692144000000",
    "number": "1467021741",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15001 KERCHEVAL AVE STE 384",
            "city": "GROSSE POINTE PARK",
            "state": "MI",
            "postal_code": "482301361",
            "telephone_number": "313-408-9179"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26522 VAN DYKE AVE",
            "city": "CENTER LINE",
            "state": "MI",
            "postal_code": "480151221",
            "telephone_number": "586-759-4400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "15001 Kercheval Ave Ste 384",
            "address_purpose": "LOCATION",
            "city": "Grosse Pointe Park",
            "state": "MI",
            "postal_code": "482301361",
            "country_code": "US",
            "telephone_number": "313-408-9179",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOSTYN",
        "first_name": "OMEGA",
        "middle_name": "C",
        "name_prefix": "Ms.",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-06-22",
        "last_updated": "2023-08-16",
        "certification_date": "2023-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MI",
            "license": "6401019468",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MI",
            "license": "6401223696",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Russell George Mitchell
• Erin Molesworth
• Dwight Vincent Moody
• Lawrence Michael Morabito II, DC
• Jenell Morris
• Ronetta Muha
• Pamela Muldrow, LLMSW
• Mycare Health Center
• Mycare Health Center
• Caitlin Myers

• Professional Counselor in Center Line, MI
• Providers in Center Line, MI by specialty
• Professional Counselor in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2023; 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.