Individual provider Active NPI

Stephanie David

  • Mental Health Counselor
  • Saint Joseph, MI
National Provider Identifier
1679250658
Registry record updated Jun 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
6451023110 Issued in MI
Practice address
830 Pleasant St Ste 201
Saint Joseph, MI 49085-2279
Phone
(269) 982-3832
NPI assigned
Jun 30, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 6451023110 MI Primary

Addresses

Primary practice location

830 Pleasant St Ste 201
Saint Joseph, MI 49085-2279

Mailing address

830 Pleasant St Ste 201
Saint Joseph, MI 49085-2279

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

LicenseStateTypeSpecialty
6451023110MIMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Donarski Center for Mental Health Counseling Mental Health CurrentSince Jul 2, 2023 Accepting new patients
Family Therapy & Development Centers Inc Mental Health CurrentSince Jul 2, 2023 Accepting new patients

Locations

830 Pleasant St
Ste 201
Saint Joseph, MI 49085
Phone (773) 953-0358

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.

NPI Registry JSON

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

{
    "created_epoch": "1688083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688083200000",
    "number": "1679250658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "830 PLEASANT ST STE 201",
            "city": "SAINT JOSEPH",
            "state": "MI",
            "postal_code": "490852279"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "830 PLEASANT ST STE 201",
            "city": "SAINT JOSEPH",
            "state": "MI",
            "postal_code": "490852279",
            "telephone_number": "269-982-3832"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVID",
        "first_name": "STEPHANIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-30",
        "last_updated": "2023-06-30",
        "certification_date": "2023-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MI",
            "license": "6451023110",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Joseph, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2023; 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.