Active NPI
Brian Perry
- Counselor
- Waterford, MI
National Provider Identifier
1609601533
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- 6451023839
- Practice address
- 4000 W Walton Blvd
Waterford, MI 48329-4191 - Phone
- (248) 461-6266
- NPI assigned
- Sep 2, 2024
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 6451023839 | MI | |
| Counselor | 101Y00000X | 6451023839 | MI | Primary |
Addresses
Primary practice location
4000 W Walton Blvd
Waterford, MI 48329-4191
Mailing address
872 Amanda LN
Pontiac, MI 48340-1379
Phone (248) 875-4726
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 |
|---|---|---|---|
| 6451023839 | MI | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1725235200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1725235200000",
"number": "1609601533",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "872 AMANDA LN",
"city": "PONTIAC",
"state": "MI",
"postal_code": "483401379",
"telephone_number": "248-875-4726"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4000 W WALTON BLVD",
"city": "WATERFORD",
"state": "MI",
"postal_code": "483294191",
"telephone_number": "248-461-6266"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PERRY",
"first_name": "BRIAN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2024-09-02",
"last_updated": "2024-09-02",
"certification_date": "2024-09-02",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "MI",
"license": "6451023839",
"primary": false
},
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "MI",
"license": "6451023839",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Waterford, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 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.