Individual provider Active NPI

Alexandra J Colvard, LPC

  • Professional Counselor
  • Bloomfield Township, MI
National Provider Identifier
1548394463
Registry record updated Aug 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
6401009266 Issued in MI
Practice address
1760 S Telegraph Rd Ste 200-220
Bloomfield Township, MI 48302-0180
Phone
(517) 882-3732
Fax
(517) 882-3633
NPI assigned
Mar 15, 2007
Last updated
Aug 14, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X
Professional Counselor 101YP2500X 6401009266 MI Primary

Addresses

Primary practice location

1760 S Telegraph Rd Ste 200-220
Bloomfield Township, MI 48302-0180

Mailing address

1760 S Telegraph Rd Ste 200-220
Bloomfield Township, MI 48302-0180
Phone (517) 882-3732

Other identifiers 1

IdentifierTypeStateIssuer
820844OtherMISUBSTANCE ABUSE LICENSE

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
I20231118000145 MI Practitioner - Mental Health Counselor 7618325333 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Wayne State University School of Medicine, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Downriver Mental Health Clinic PCGroup PAC ID 7911995139, 289 clinicians

Practice addresses (Care Compare)

1760 S Telegraph Rd
Suite 220
Bloomfield Hills, MI 48302-0183
Phone (517) 882-3732

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Downriver Mental Health Clinic PC Professional CurrentSince Jan 1, 2024 Accepting new patients
Downriver Mental Health Clinic PC Mental Health CurrentSince Jan 1, 2024 Accepting new patients

Locations

1760 S Telegraph Rd
Ste 220
Bloomfield Hills, MI 48302
Phone (248) 587-7618

1760 S Telegraph Rd
Ste 200220
Bloomfield Township, MI 48302
Phone (734) 285-8282

1400 Abbot Rd
Ste 400
East Lansing, MI 48823
Phone (810) 220-2787

29201 Telegraph Rd
Ste 550
Southfield, MI 48034
Phone (248) 213-0501

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1173916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691971200000",
    "number": "1548394463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1760 S TELEGRAPH RD STE 200-220",
            "city": "BLOOMFIELD TOWNSHIP",
            "state": "MI",
            "postal_code": "483020180",
            "telephone_number": "517-882-3732",
            "fax_number": "517-882-3633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1760 S TELEGRAPH RD STE 200-220",
            "city": "BLOOMFIELD TOWNSHIP",
            "state": "MI",
            "postal_code": "483020180",
            "telephone_number": "517-882-3732",
            "fax_number": "517-882-3633"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLVARD",
        "first_name": "ALEXANDRA",
        "middle_name": "J",
        "name_prefix": "Ms.",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-15",
        "last_updated": "2023-08-14",
        "certification_date": "2023-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MI",
            "license": "6401009266",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SUBSTANCE ABUSE LICENSE",
            "identifier": "820844",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomfield Township, MI

Sources for this page

Verify at the official NPI Registry.