Tisdel Counseling Services LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

6801087231 Issued in MI

Legal business name

TISDEL COUNSELING SERVICES LLC

Practice address

1703 S Despelder St
Grand Haven, MI 49417-2649

Phone

(616) 842-9160

NPI assigned

Oct 23, 2017

Organization subpart

No

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

Authorized official

Name

Krista Tisdel, LMSW

Title

Clinical Masters Social Worker

Phone

(616) 502-5474

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1508716800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1508716800000",
    "number": "1558872127",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "515 RIVER ST",
            "city": "SPRING LAKE",
            "state": "MI",
            "postal_code": "494561907",
            "telephone_number": "616-502-5474"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1703 S DESPELDER ST",
            "city": "GRAND HAVEN",
            "state": "MI",
            "postal_code": "494172649",
            "telephone_number": "616-842-9160"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TISDEL COUNSELING SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-10-23",
        "last_updated": "2017-10-23",
        "status": "A",
        "authorized_official_last_name": "TISDEL",
        "authorized_official_first_name": "KRISTA",
        "authorized_official_title_or_position": "CLINICAL MASTERS SOCIAL WORKER",
        "authorized_official_telephone_number": "616-502-5474",
        "authorized_official_credential": "LMSW"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "MI",
            "license": "6801087231",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Providers in Grand Haven, MI by specialty
• Community/Behavioral Health Agency in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2017; 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.