Active NPI
Julie Anne McKelvie, SW
- Addiction (Substance Use Disorder) Counselor
- Brimley, MI
National Provider Identifier
1689872533
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- 104380
- Practice address
- 12124 W Lakeshore Dr
Brimley, MI 49715-9319 - Phone
- (906) 248-5527
- Fax
- (906) 248-5765
- NPI assigned
- Jul 3, 2007
- Last updated
- Nov 8, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 104380 | MI | Primary |
| Social Worker | 104100000X | 6803085443 | MI |
Addresses
Primary practice location
12124 W Lakeshore Dr
Brimley, MI 49715-9319
Mailing address
12124 W Lakeshore Dr
Brimley, MI 49715-9319
Phone (906) 248-5527
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
| License | State | Type | Specialty |
|---|---|---|---|
| 104380 | MI | MD | Addiction (Substance Use Disorder) Counselor |
| 6803085443 | MI | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1183420800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1194480000000",
"number": "1689872533",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12124 W LAKESHORE DR",
"city": "BRIMLEY",
"state": "MI",
"postal_code": "497159319",
"telephone_number": "906-248-5527",
"fax_number": "906-248-5765"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12124 W LAKESHORE DR",
"city": "BRIMLEY",
"state": "MI",
"postal_code": "497159319",
"telephone_number": "906-248-5527",
"fax_number": "906-248-5765"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCKELVIE",
"first_name": "JULIE",
"middle_name": "ANNE",
"credential": "SW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-07-03",
"last_updated": "2007-11-08",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "MI",
"license": "104380",
"primary": true
},
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "MI",
"license": "6803085443",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brimley, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.