Active NPI
Frank Edward Tabaczka, LLPC
- Professional Counselor
- Muskegon, MI
National Provider Identifier
1902041155
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- L1351419
- Practice address
- 1095 3Rd St
Muskegon, MI 49441-1976 - Phone
- (231) 726-4735
- Fax
- (231) 722-0789
- NPI assigned
- Dec 2, 2008
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | L1351419 | MI | |
| Professional Counselor | 101YP2500X | L1351419 | MI | Primary |
Addresses
Primary practice location
1095 3Rd St
Muskegon, MI 49441-1976
Mailing address
1095 3Rd St
Muskegon, MI 49441-1976
Phone (231) 726-4735
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1712452 | Medicaid | MI |
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 |
|---|---|---|---|
| L1351419 | MI | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1228176000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1228176000000",
"number": "1902041155",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1095 3RD ST",
"city": "MUSKEGON",
"state": "MI",
"postal_code": "494411976",
"telephone_number": "231-726-4735",
"fax_number": "231-722-0789"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1095 3RD ST",
"city": "MUSKEGON",
"state": "MI",
"postal_code": "494411976",
"telephone_number": "231-726-4735",
"fax_number": "231-722-0789"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TABACZKA",
"first_name": "FRANK",
"middle_name": "EDWARD",
"credential": "LLPC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-12-02",
"last_updated": "2008-12-02",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "MI",
"license": "L1351419",
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "MI",
"license": "L1351419",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1712452",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Muskegon, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.