Active NPI
Christina Rose Bonacorsi, LPC
- Professional Counselor
- Southfield, MI
National Provider Identifier
1568759777
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 640102524
- Practice address
- 26545 American Dr
Southfield, MI 48034-6115 - Phone
- (800) 395-3223
- NPI assigned
- Jul 8, 2011
- Last updated
- Jul 15, 2025
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 640102524 | MI | Primary |
Addresses
Primary practice location
26545 American Dr
Southfield, MI 48034-6115
Mailing address
26545 American Dr
Southfield, MI 48034-6115
Phone (800) 395-3223
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 750910402 | Other | MI | BLUE CROSS |
Other names 1
- Christina Polk
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 640102524 | MI | MD | Professional Counselor |
Organizations & group practices 1
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.
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dba New Oakland Child-Adolescent and Family Center
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- NPI 1609882067
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1310083200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1752537600000",
"number": "1568759777",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "26545 AMERICAN DR",
"city": "SOUTHFIELD",
"state": "MI",
"postal_code": "480346115",
"telephone_number": "800-395-3223"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "26545 AMERICAN DR",
"city": "SOUTHFIELD",
"state": "MI",
"postal_code": "480346115",
"telephone_number": "800-395-3223"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BONACORSI",
"first_name": "CHRISTINA",
"middle_name": "ROSE",
"credential": "LPC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-07-08",
"last_updated": "2025-07-15",
"certification_date": "2025-07-15",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "MI",
"license": "640102524",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS",
"identifier": "750910402",
"state": "MI"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "CHRISTINA",
"last_name": "POLK",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Southfield, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.