Port Huron Counseling Behavioral Specialist

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

4301055449 Issued in MI

Legal business name

PORT HURON COUNSELING BEHAVIORAL SPECIALIST

Practice address

309 McMorran Blvd
Port Huron, MI 48060-3807

Phone

(810) 488-7974

NPI assigned

Dec 3, 2008

Organization subpart

No

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

Authorized official

Name

Shelley Taglione

Title

Billing Co

Phone

(734) 414-0754

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1228262400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1228262400000",
    "number": "1912142035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "42928 VERSAILLES RD",
            "city": "CANTON",
            "state": "MI",
            "postal_code": "481872344",
            "telephone_number": "810-488-7974"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "309 MCMORRAN BLVD",
            "city": "PORT HURON",
            "state": "MI",
            "postal_code": "480603807",
            "telephone_number": "810-488-7974"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PORT HURON COUNSELING BEHAVIORAL SPECIALIST",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-12-03",
        "last_updated": "2008-12-03",
        "status": "A",
        "authorized_official_last_name": "TAGLIONE",
        "authorized_official_first_name": "SHELLEY",
        "authorized_official_title_or_position": "BILLING CO",
        "authorized_official_telephone_number": "734-414-0754"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MI",
            "license": "4301055449",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "2607611202",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Victor Paul Polito Jr.
• Thomas P Pope, LLP
• Port Huron Anesthesiology, PC
• Port Huron Behavioral Specialists
• Port Huron Clinic P.C.
• Port Huron Family Care PLLC
• Port Huron Hospital Crna Billing, LLC
• Port Huron Internal Medicine
• Port Huron Internal Medicine Associates
• Port Huron Mercy Family Care Inc

• Psychiatry Physician in Port Huron, MI
• Providers in Port Huron, MI by specialty
• Psychiatry Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 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.

Verify at the official NPI Registry.