Active NPI
I C W a Counseling
- Counselor
- Redford, MI
National Provider Identifier
1477326940
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- Legal business name
- I C W A COUNSELING
- Practice address
- 25447 Plymouth Rd
Redford, MI 48239-2022 - Phone
- (313) 424-0769
- NPI assigned
- Nov 6, 2023
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Diane Curry, LPC
- Title
- Owner
- Phone
- (313) 743-4113
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | Primary |
Addresses
Primary practice location
25447 Plymouth Rd
Redford, MI 48239-2022
Mailing address
11675 Farley
Redford, MI 48239-2470
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20240223002526 | MI | Part B Supplier - Clinic/Group Practice | 9436594942 | Practice locations: Redford, MI |
National Provider Directory
National Provider DirectoryLocations
25447 Plymouth Rd
Redford, MI 48239
Phone (313) 424-0769
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1699228800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1701302400000",
"number": "1477326940",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11675 FARLEY",
"city": "REDFORD",
"state": "MI",
"postal_code": "482392470"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "25447 PLYMOUTH RD",
"city": "REDFORD",
"state": "MI",
"postal_code": "482392022",
"telephone_number": "313-424-0769"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "I C W A COUNSELING",
"organizational_subpart": "NO",
"enumeration_date": "2023-11-06",
"last_updated": "2023-11-30",
"certification_date": "2023-11-30",
"status": "A",
"authorized_official_last_name": "CURRY",
"authorized_official_first_name": "DIANE",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "313-743-4113",
"authorized_official_credential": "LPC"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Counselor",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Redford, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2023; 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.