Individual provider Active NPI

Jennifer Kristen Korzeniowski, MA, LPC, NCC

  • Counselor
  • Clinton Township, MI
National Provider Identifier
1881844306
Registry record updated Jun 19, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
6401010820 Issued in MI
Practice address
42669 Garfield Rd
Clinton Township, MI 48038-1653
Phone
(586) 412-5321
Fax
(586) 412-5327
NPI assigned
Sep 19, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 19, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X 6401010820 MI Primary

Addresses

Primary practice location

42669 Garfield Rd
Clinton Township, MI 48038-1653

Mailing address

6549 Town Center Dr
Suite a
Clarkston, MI 48346-4824
Phone (248) 620-6400

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20260325003963 NY Practitioner - Mental Health Counselor 7618452822

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2007
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

12766 Meadow Hawk Dr
Fort Myers, FL 33912-1491

3249 Kingsbridge Ave
Bronx, NY 10463-5514

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
6401010820MIMDCounselor

Practice roles

OrganizationSpecialtyStatusNew patients
Building Bright Futures PLLC Counselor CurrentSince Jun 21, 2020 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1221782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592524800000",
    "number": "1881844306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6549 TOWN CENTER DR",
            "address_2": "SUITE A",
            "city": "CLARKSTON",
            "state": "MI",
            "postal_code": "483464824",
            "telephone_number": "248-620-6400",
            "fax_number": "248-620-6405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "42669 GARFIELD RD",
            "city": "CLINTON TOWNSHIP",
            "state": "MI",
            "postal_code": "480381653",
            "telephone_number": "586-412-5321",
            "fax_number": "586-412-5327"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KORZENIOWSKI",
        "first_name": "JENNIFER",
        "middle_name": "KRISTEN",
        "name_prefix": "Ms.",
        "credential": "MA, LPC, NCC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-09-19",
        "last_updated": "2020-06-19",
        "certification_date": "2020-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "MI",
            "license": "6401010820",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clinton Township, MI

Sources for this page

Verify at the official NPI Registry.