Creekside Counseling Group LLC
Organization Active NPI Clinical Social Worker · Grand Blanc, MI
NPI 1619550860 · NPPES record last updated Aug 22, 2023
Key facts
- NPI
- 1619550860
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Clinical Social Worker 1041C0700X
- Legal business name
- CREEKSIDE COUNSELING GROUP LLC
- Practice address
- 10683 S Saginaw St Ste B
Grand Blanc, MI 48439-8127 - Phone
- (810) 771-4074
- Fax
- (810) 866-4450
- NPI assigned
- May 4, 2021
- Organization subpart
- No
Authorized official
- Name
- Heather Renee Murphy, LMSW
- Title
- Owner
- Phone
- (810) 422-3708
Practitioners 59
-
Chelsee Baker, LMSW
-
Lindsay Bhirdo, MSW
-
Shai Moshe Brosh, PHD
-
Deborah Carter, LPC
-
Therese Ann Carter, LMSW
-
Ashly Crosby, NP
-
Jasmine Edwards, LMSW
-
Karhonda Fails, LMSW
-
Mershell Anntanet Flinnon, LLMSW
-
Laura Freeman, LMFT
-
Joanne K Ingram, LMSW
-
Carla Anne Koon, LLPC
-
Robin Lynn Norman, LMSW
-
Giovanni Peter Parochetti, PMHNP -BC
-
Tamara Pobocik, PMHNP-BC
-
Tanya Roe, LMSW
-
Joshua J Shilling, LMSW, CCS, CAADC
-
Susan E Smallwood, LPC
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MI
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20210713000742 | MI | Part B Supplier - Clinic/Group Practice | 9133521255 |
Receives reassigned benefits from 47 practitioners Practice locations: Grand Blanc, MI; Oxford, MI; Fenton, MI |
National Provider Directory
Locations
15173 North Rd
Ste 100
Fenton, MI 48430
Phone (810) 208-0879
10801 S Saginaw St
Ste D
Grand Blanc, MI 48439
Phone (810) 771-4074
1370 S Lapeer Rd
Oxford, MI 48371
Phone (586) 651-5849
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor |
101Y00000X | |||
| Mental Health Counselor |
101YM0800X | |||
| Professional Counselor |
101YP2500X | |||
| Clinical Psychologist |
103TC0700X | |||
| Social Worker |
104100000X | |||
| Clinical Social Worker |
1041C0700X | Yes | ||
| Marriage & Family Therapist |
106H00000X | |||
| Medical Physician Assistant |
363AM0700X | |||
| Psychiatric/Mental Health Nurse Practitioner |
363LP0808X |
Addresses
Primary practice location
10683 S Saginaw St Ste B
Grand Blanc, MI 48439-8127
Mailing address
10683 S Saginaw St Ste B
Grand Blanc, MI 48439-8127
Phone (810) 771-4074
Other practice location 1
7227 Fenton Rd
Grand Blanc, MI 48439-8961
Phone (810) 771-4074
Other practice location 2
15173 North Rd Ste 100
Fenton, MI 48430-1381
Phone (810) 771-4074
Other providers in Grand Blanc, MI
- Heather Cravener
- Abigail Christine Crawford
- Candace Ray Crawley
- Noel Creager
- Creekside Counseling Group
- Zachary Raymond Cresap
- Crescent Counseling
- Crescent Counseling
- Susan Crew
- Alexie Cronenvhet
All providers in Grand Blanc, MI · Clinical Social Worker in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 22, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.