NPIMap

Organization Active NPI

Desert Streams P C

  • Psychologist
  • Kalamazoo, MI
National Provider Identifier
1740295492
Registry record updated Aug 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
Legal business name
DESERT STREAMS P C
Practice address
2019 Rambling Rd
Kalamazoo, MI 49008-1630
Phone
(269) 345-0909
Fax
(269) 345-4985
NPI assigned
Jul 30, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2022

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

Authorized official

Name
Mr. Andrew Steven Brown, MA, LPCNPI 1841745700
Title
President/Owner
Phone
(269) 345-0909

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X MI
PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103T00000X MI Primary
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X MI
Marriage & Family TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 106H00000X MI

Addresses

Primary practice location

2019 Rambling Rd
Kalamazoo, MI 49008-1630

Mailing address

2019 Rambling Rd
Kalamazoo, MI 49008-1630
Phone (269) 345-0909

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050617000194 MI Part B Supplier - Clinic/Group Practice 2961446273 Receives reassigned benefits from 17 practitioners
Practice locations: Battle Creek, MI; Kalamazoo, MI

National Provider Directory

National Provider Directory
Tax ID family
Desert Streams Christian Counseling3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Locations

9 Heritage Oak Ln
Battle Creek, MI 49015
Phone (268) 345-0909

2019 Rambling Rd
Kalamazoo, MI 49008
Phone (269) 345-0909

Practitioners & affiliated clinicians

Practitioners 18

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.

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1154217600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1661212800000",
    "number": "1740295492",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2019 RAMBLING RD",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490081630",
            "telephone_number": "269-345-0909",
            "fax_number": "269-345-4985"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2019 RAMBLING RD",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490081630",
            "telephone_number": "269-345-0909",
            "fax_number": "269-345-4985"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DESERT STREAMS P C",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-30",
        "last_updated": "2022-08-23",
        "certification_date": "2022-08-23",
        "status": "A",
        "authorized_official_last_name": "BROWN",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_middle_name": "STEVEN",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "269-345-0909",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MA, LPC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "MI",
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": "MI",
            "license": null,
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Marriage & Family Therapist",
            "state": "MI",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kalamazoo, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.