NPIMap

Organization Active NPI

Genesee County Community Mental Health

  • Counseling Psychologist
  • Flint, MI
National Provider Identifier
1659674059
Registry record updated Dec 8, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Counseling PsychologistTaxonomy code 103TC1900X
License
6301014667 Issued in MI
Legal business name
GENESEE COUNTY COMMUNITY MENTAL HEALTH
Practice address
420 W 5TH Ave
Flint, MI 48503-2445
Phone
(810) 257-3714
NPI assigned
Dec 8, 2010
Last updated
Dec 8, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2010

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

Authorized official

Name
Mrs. Takiyah Shani' Jackson, MA TLLPNPI 1598037665
Title
Consultative Services
Phone
(810) 257-3714

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counseling Psychologist 103TC1900X 6301014667 MI Primary

Addresses

Primary practice location

420 W 5TH Ave
Flint, MI 48503-2445

Mailing address

420 W 5TH Ave
Flint, MI 48503-2445
Phone (810) 257-3714

National Provider Directory

National Provider Directory
Tax ID family
County of Genesee Office of Controller18 organizations share this tax ID, including this one

Other organizations with this tax ID 17

Organizations that report the same tax identification number in the National Provider Directory.

View all 17

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1291766400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1291766400000",
    "number": "1659674059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 W 5TH AVE",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485032445",
            "telephone_number": "810-257-3714"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 W 5TH AVE",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485032445",
            "telephone_number": "810-257-3714"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GENESEE COUNTY COMMUNITY MENTAL HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-12-08",
        "last_updated": "2010-12-08",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "TAKIYAH",
        "authorized_official_middle_name": "SHANI'",
        "authorized_official_title_or_position": "CONSULTATIVE SERVICES",
        "authorized_official_telephone_number": "810-257-3714",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MA TLLP"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "MI",
            "license": "6301014667",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flint, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.