Individual provider Active NPI

Stephanie Priskorn, LLPC

  • Mental Health Counselor
  • Clinton Township, MI
National Provider Identifier
1497304935
Registry record updated Sep 7, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
6401017616 Issued in MI
Practice address
42815 Garfield Rd Ste 201
Clinton Township, MI 48038-1143
Phone
(586) 333-5328
NPI assigned
Sep 7, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 7, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 6401017616 MI Primary

Addresses

Primary practice location

42815 Garfield Rd Ste 201
Clinton Township, MI 48038-1143

Mailing address

42815 Garfield Rd Ste 201
Clinton Township, MI 48038-1143
Phone (586) 333-5328

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
6401017616MIMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Macomb Therapy Group, PLLC Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1567814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1567814400000",
    "number": "1497304935",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "42815 GARFIELD RD STE 201",
            "city": "CLINTON TOWNSHIP",
            "state": "MI",
            "postal_code": "480381143",
            "telephone_number": "586-333-5328"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "42815 GARFIELD RD STE 201",
            "city": "CLINTON TOWNSHIP",
            "state": "MI",
            "postal_code": "480381143",
            "telephone_number": "586-333-5328"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRISKORN",
        "first_name": "STEPHANIE",
        "credential": "LLPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-07",
        "last_updated": "2019-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MI",
            "license": "6401017616",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clinton Township, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2019; 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.