Individual provider Active NPI

Giawanna Peterson-Rochon, LMSW

  • Mental Health Counselor
  • Redford, MI
National Provider Identifier
1538327382
Registry record updated Feb 18, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
6801083169 Issued in MI
Practice address
26520 Grand River Ave
Suite 121
Redford, MI 48240-1506
Phone
(313) 533-5652
Fax
(313) 533-5644
NPI assigned
May 29, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 18, 2010

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 6801083169 MI Primary

Addresses

Primary practice location

26520 Grand River Ave
Suite 121
Redford, MI 48240-1506

Mailing address

26520 Grand River Ave
Suite 121
Redford, MI 48240-1506
Phone (313) 533-5652

Other identifiers 1

IdentifierTypeStateIssuer
0896890OtherBCBS

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20041201000171 MI Practitioner - Clinical Social Worker 9234194366 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Angel Counseling Inc.Group PAC ID 9436114568, 4 clinicians

Practice addresses (Care Compare)

26520 Grand River Ave
Suite 121
Redford, MI 48240-1506
Phone (313) 533-5652

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6801083169MIMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Angel Counseling Inc. CurrentSince Jul 1, 2002 Accepting new patients
Linsk Psychiatry Services P C PastSince Aug 15, 2015 Accepting new patients

Locations

26847 Grand River Ave
Redford, MI 48240
Phone (313) 533-5652

26520 Grand River Ave
Redford, MI 48240
Phone (313) 533-5652

26520 Grand River Ave
Ste 121
Redford, MI 48240
Phone (313) 533-5652

Organizations & group practices 2

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": "1212019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1266451200000",
    "number": "1538327382",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26520 GRAND RIVER AVE",
            "address_2": "SUITE 121",
            "city": "REDFORD",
            "state": "MI",
            "postal_code": "482401506",
            "telephone_number": "313-533-5652",
            "fax_number": "313-533-5644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26520 GRAND RIVER AVE",
            "address_2": "SUITE 121",
            "city": "REDFORD",
            "state": "MI",
            "postal_code": "482401506",
            "telephone_number": "313-533-5652",
            "fax_number": "313-533-5644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON-ROCHON",
        "first_name": "GIAWANNA",
        "name_prefix": "Mrs.",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-05-29",
        "last_updated": "2010-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MI",
            "license": "6801083169",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0896890",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Redford, MI

Sources for this page

Verify at the official NPI Registry.