Individual provider Active NPI

Jennifer J Schroeder-Parker, COUNSELOR

  • Addiction (Substance Use Disorder) Counselor
  • Ypsilanti, MI
National Provider Identifier
1518530765
Registry record updated Jul 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
2-00953 Issued in MI
Practice address
6061 Textile Rd
Ypsilanti, MI 48197-8990
Phone
(734) 834-6934
NPI assigned
Jul 23, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 23, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YA0400X 2-00953 MI Primary

Addresses

Primary practice location

6061 Textile Rd
Ypsilanti, MI 48197-8990

Mailing address

6061 Textile Rd
Ypsilanti, MI 48197-8990
Phone (734) 834-6934

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
2-00953MIMDAddiction (Substance Use Disorder) Counselor

NPI Registry JSON

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

{
    "created_epoch": "1626998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626998400000",
    "number": "1518530765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6061 TEXTILE RD",
            "city": "YPSILANTI",
            "state": "MI",
            "postal_code": "481978990",
            "telephone_number": "734-834-6934"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6061 TEXTILE RD",
            "city": "YPSILANTI",
            "state": "MI",
            "postal_code": "481978990",
            "telephone_number": "734-834-6934"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHROEDER-PARKER",
        "first_name": "JENNIFER",
        "middle_name": "J",
        "name_prefix": "Mrs.",
        "credential": "COUNSELOR",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-07-23",
        "last_updated": "2021-07-23",
        "certification_date": "2021-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MI",
            "license": "2-00953",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ypsilanti, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2021; 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.