Burton Professional Counseling PLLC
Organization Active NPI Counselor · Burton, MI
NPI 1831782663 · NPPES record last updated Feb 12, 2021
Key facts
- NPI
- 1831782663
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Counselor 101Y00000X
- Legal business name
- BURTON PROFESSIONAL COUNSELING PLLC
- Practice address
- 1481 S Center Rd Ste B
Burton, MI 48509-1779 - Phone
- (810) 820-8706
- NPI assigned
- Feb 12, 2021
- Organization subpart
- No
Authorized official
- Name
- Hossam Shukairy
- Title
- Credentialailing
- Phone
- (810) 691-7738
Practitioners 3
-
Ranim Baroudi, LPC
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MI
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20231213000473 | MI | Part B Supplier - Clinic/Group Practice | 9931577152 |
Receives reassigned benefits from 2 practitioners Practice locations: Burton, MI; Flushing, MI |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor |
101Y00000X | Yes |
Addresses
Primary practice location
1481 S Center Rd Ste B
Burton, MI 48509-1779
Mailing address
1481 S Center Rd Ste B
Burton, MI 48509-1779
Phone (810) 820-8706
Other names
- BURTON PROFESSIONAL COUNSELING
Other providers in Burton, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 12, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.