Individual provider Active NPI

Crystal Leigh Policelli

  • Peer Specialist
  • Redford, MI
National Provider Identifier
1902596968
Registry record updated Sep 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Peer SpecialistTaxonomy code 175T00000X
Practice address
24435 Plymouth Rd
Redford, MI 48239-1616
Phone
(313) 918-4217
Fax
(313) 450-0400
NPI assigned
May 11, 2023
Last updated
Sep 30, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Peer Specialist 175T00000X MI Primary

Addresses

Primary practice location

24435 Plymouth Rd
Redford, MI 48239-1616

Mailing address

24435 Plymouth Rd
Redford, MI 48239-1616
Phone (313) 918-4217

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

Practice roles

OrganizationSpecialtyStatusNew patients
Lincoln Behavioral Services PastSince Oct 5, 2025 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1683763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759190400000",
    "number": "1902596968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24435 PLYMOUTH RD",
            "city": "REDFORD",
            "state": "MI",
            "postal_code": "482391616",
            "telephone_number": "313-918-4217",
            "fax_number": "313-450-0400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24435 PLYMOUTH RD",
            "city": "REDFORD",
            "state": "MI",
            "postal_code": "482391616",
            "telephone_number": "313-918-4217",
            "fax_number": "313-450-0400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLICELLI",
        "first_name": "CRYSTAL",
        "middle_name": "LEIGH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-11",
        "last_updated": "2025-09-30",
        "certification_date": "2025-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "MI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Redford, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.