NPIMap

Organization Active NPI

Mosaic Counseling

  • Mental Health Counselor
  • Clarkston, MI
National Provider Identifier
1518519230
Registry record updated Jul 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
MOSAIC COUNSELING
Practice address
4545 Clawson Tank Dr
Clarkston, MI 48346-2581
Phone
(248) 431-0475
NPI assigned
Jul 12, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2019

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

Authorized official

Name
Jennifer Lucas, LPCNPI 1649683475
Title
Owner
Phone
(248) 431-0475

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
Mental Health CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YM0800X Primary

Addresses

Primary practice location

4545 Clawson Tank Dr
Clarkston, MI 48346-2581

Mailing address

4545 Clawson Tank Dr
Clarkston, MI 48346-2581

Other identifiers 1

IdentifierTypeStateIssuer
0H73582OtherBLUE CROSS PIN

National Provider Directory

National Provider Directory

Locations

4545 Clawson Tank Dr
Clarkston, MI 48346
Phone (248) 431-0475

Practitioners & affiliated clinicians

Practitioners 1

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": "1562889600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1562889600000",
    "number": "1518519230",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4545 CLAWSON TANK DR",
            "city": "CLARKSTON",
            "state": "MI",
            "postal_code": "483462581"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4545 CLAWSON TANK DR",
            "city": "CLARKSTON",
            "state": "MI",
            "postal_code": "483462581",
            "telephone_number": "248-431-0475"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOSAIC COUNSELING",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-07-12",
        "last_updated": "2019-07-12",
        "status": "A",
        "authorized_official_last_name": "LUCAS",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "248-431-0475",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS PIN",
            "identifier": "0H73582",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clarkston, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 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.