Charissa Anne Isaacs, MA LPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

6401012280 Issued in MI

Practice address

100 Northbound Gratiot Ave
Mount Clemens, MI 48043

Phone

(586) 783-2950

Fax

(586) 690-4333

NPI assigned

Jan 1, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: charissa.isaacs.1@24284.direct.athenahealth.com

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.

• Renewal Christian Counseling Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Mount Clemens, MI
  • NPI 1548211535

  Mental Health, MI

  Medicare reassignment NPD
• Renewal Christian Counseling Center Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Fort Gratiot, MI
  • NPI 1174799209
  NPD (past)
• Renewal Christian Counseling Inc

  • Clinical Social Worker
  • Mount Clemens, MI
  • NPI 1548648322

  Mental Health

  NPD (past)

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

{
    "created_epoch": "1293840000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562803200000",
    "number": "1497059786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 NORTHBOUND GRATIOT AVE",
            "city": "MOUNT CLEMENS",
            "state": "MI",
            "postal_code": "480432301",
            "telephone_number": "586-783-2950",
            "fax_number": "586-690-4333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 NORTHBOUND GRATIOT AVE",
            "city": "MOUNT CLEMENS",
            "state": "MI",
            "postal_code": "48043",
            "telephone_number": "586-783-2950",
            "fax_number": "586-690-4333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ISAACS",
        "first_name": "CHARISSA",
        "middle_name": "ANNE",
        "credential": "MA LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-01-01",
        "last_updated": "2019-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MI",
            "license": "6401012280",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1708146",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Internal Medicine Associates of Mt. Clemens, PC
• Irb Medical Equipment LLC
• Matthew Irick, DO
• Brayden Irving, MD
• Ronald Brian Irwin, MD
• Isett Enterprises Inc.
• Thomas Isett
• Andrew M Jablonowski, N.P.
• Tyler Jablonski, DO
• William Matthew Jacobs, D.O.

• All providers in Mount Clemens, MI
• Mental Health Counselor in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.