Phillip James Zezulak, LPC, CAADC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

6401019593 Issued in MI

Practice address

1480 N M 52 Ste 1
Owosso, MI 48867-1025

Phone

(989) 723-8239

Fax

(989) 723-8230

NPI assigned

Sep 15, 2015

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Catholic Charities of Shiawassee and Genesee CountiesGroup PAC ID 9537158068, 6 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Catholic Charities of Shiawassee and Genesee Counties

  • Mental Health Counselor
  • Owosso, MI
  • NPI 1801819149
  Medicare reassignment Care Compare group NPD
• Catholic Charities of Shiawassee and Genesee Counties

  • Mental Health Counselor
  • Owosso, MI
  • NPI 1689155590
  NPD (past)

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

{
    "created_epoch": "1442275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670889600000",
    "number": "1740659218",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1480 N M 52 STE 1",
            "city": "OWOSSO",
            "state": "MI",
            "postal_code": "488671025",
            "telephone_number": "989-723-8239",
            "fax_number": "989-723-8230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1480 N M 52 STE 1",
            "city": "OWOSSO",
            "state": "MI",
            "postal_code": "488671025",
            "telephone_number": "989-723-8239",
            "fax_number": "989-723-8230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZEZULAK",
        "first_name": "PHILLIP",
        "middle_name": "JAMES",
        "name_prefix": "Mr.",
        "credential": "LPC, CAADC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-09-15",
        "last_updated": "2022-12-13",
        "certification_date": "2022-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MI",
            "license": "6401019593",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MI",
            "license": "6401019593",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MI",
            "license": "6401019593",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emily Yoder
• Brittany Yonts, BS
• Andrew Vincent Young, RPH.
• Youngworkz LLC
• John R. Zang-Bodis, D.D.S., M.D.S.
• Elaine Joy Zimmerman, RNCDE
• Kyle Robert Zimmerman, D.C.
• Diane Carol Zuckschwerdt, MA,CCC-A
• Stacy Zwolensky, LLMFT

• Professional Counselor in Owosso, MI
• Providers in Owosso, MI by specialty
• Professional Counselor in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.