Counseling Consulting and Supervision Services LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

6401012467 Issued in MI

Legal business name

COUNSELING CONSULTING AND SUPERVISION SERVICES LLC

Practice address

25701 W 12 Mile Rd
# 305
Southfield, MI 48034-1822

Phone

(248) 716-8029

NPI assigned

Mar 9, 2015

Organization subpart

No

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

Authorized official

Name

Adrian L Johnson, MA, CRC, LPC

Title

Clinical Director

Phone

(248) 716-8029

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1425859200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1425859200000",
    "number": "1689067118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25701 W 12 MILE RD",
            "address_2": "# 305",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480341822",
            "telephone_number": "248-716-8029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25701 W 12 MILE RD",
            "address_2": "# 305",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480341822",
            "telephone_number": "248-716-8029"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COUNSELING CONSULTING AND SUPERVISION SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-03-09",
        "last_updated": "2015-03-09",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "ADRIAN",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "248-716-8029",
        "authorized_official_credential": "MA, CRC, LPC"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "MI",
            "license": "6401012467",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Community/Behavioral Health Agency in Southfield, MI
• Providers in Southfield, MI by specialty
• Community/Behavioral Health Agency in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2015; 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.