Active NPI
Christopher Costello, LLPC
- Professional Counselor
- Norton Shores, MI
National Provider Identifier
1609529262
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 6451023591
- Practice address
- 640 Seminole Rd
Norton Shores, MI 49441-4720 - Phone
- (231) 724-1111
- NPI assigned
- Feb 2, 2022
- Sex
- Male
- 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 | 6451023591 | MI | Primary |
Addresses
Primary practice location
640 Seminole Rd
Norton Shores, MI 49441-4720
Mailing address
376 E Apple Ave
Muskegon, MI 49442-3466
Phone (231) 724-1111
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
| License | State | Type | Specialty |
|---|---|---|---|
| 6451023591 | MI | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Life Journey PLLC | Past | Accepting new patients | |
| County of Muskegon | Past | Accepting new patients |
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.
-
- Skilled Nursing Facility
- Muskegon, MI
- NPI 1659440816
-
- Psychologist
- Grand Rapids, MI
- NPI 1538531017
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1643760000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1717977600000",
"number": "1609529262",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "376 E APPLE AVE",
"city": "MUSKEGON",
"state": "MI",
"postal_code": "494423466",
"telephone_number": "231-724-1111"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "640 SEMINOLE RD",
"city": "NORTON SHORES",
"state": "MI",
"postal_code": "494414720",
"telephone_number": "231-724-1111"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COSTELLO",
"first_name": "CHRISTOPHER",
"credential": "LLPC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-02-02",
"last_updated": "2024-06-10",
"certification_date": "2024-04-29",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "MI",
"license": "6451023591",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Norton Shores, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.