Winston Bourne, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

6401008093 Issued in MI

Practice address

11457 Shoemaker St
Detroit, MI 48213-3418

Phone

(313) 961-3700

Fax

(313) 961-3769

NPI assigned

Sep 20, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

CNS HealthcareGroup PAC ID 8729980198, 24 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• CNS Healthcare

  • Psychiatry Physician
  • Novi, MI
  • NPI 1770538068
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724630400000",
    "number": "1639277015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11457 SHOEMAKER ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482133418",
            "telephone_number": "313-331-3435",
            "fax_number": "313-921-9247"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11457 SHOEMAKER ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482133418",
            "telephone_number": "313-961-3700",
            "fax_number": "313-961-3769"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOURNE",
        "first_name": "WINSTON",
        "name_prefix": "Ms.",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-20",
        "last_updated": "2024-08-26",
        "certification_date": "2024-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MI",
            "license": "6401008093",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE NUMBER",
            "identifier": "6401008093",
            "state": "MI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "pcerecords.cnsmi@direct.mihn.net",
            "affiliation": "Y",
            "affiliationName": "CNS Healthcare",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "24230 Karim Blvd",
            "address_2": "Suite 100",
            "city": "Novi",
            "state": "MI",
            "country_code": "US",
            "postal_code": "483752960",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Asmaa Boulehia
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• Boulevard Temple Care Center, LLC
• Matthew Boulis, DO
• Boundless Eagles Outreach Ministry
• Latoya Bournes
• David Lee Bouwman, MD
• Adrienne Nicole Bouyer, NURSE PRACTITIONER
• Karee Bovee
• Bow Tie Transportation, LLC

• Professional Counselor in Detroit, MI
• Providers in Detroit, MI by specialty
• Professional Counselor in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.