Connective Counseling PLLC

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

CONNECTIVE COUNSELING PLLC

Practice address

800 Cottageview Dr Ste 1072
Traverse City, MI 49684-2322

Phone

(231) 261-1313

NPI assigned

Dec 14, 2021

Last updated

Dec 14, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Nadine Stark, LMSWNPI 1225424351

Title

Clinical Social Worker

Phone

(231) 499-0020

Specialties & licenses 1

Addresses

Electronic endpoints 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Nadine Michelle Stark, LMSW

  • Clinical Social Worker
  • Traverse City, MI
  • NPI 1225424351
  NPD Authorized official

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

{
    "created_epoch": "1639440000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1639440000000",
    "number": "1922767235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7129 HILLTOP AVE",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496861882",
            "telephone_number": "231-499-0020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 COTTAGEVIEW DR STE 1072",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496842322",
            "telephone_number": "231-261-1313"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONNECTIVE COUNSELING PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-12-14",
        "last_updated": "2021-12-14",
        "certification_date": "2021-12-14",
        "status": "A",
        "authorized_official_last_name": "STARK",
        "authorized_official_first_name": "NADINE",
        "authorized_official_title_or_position": "CLINICAL SOCIAL WORKER",
        "authorized_official_telephone_number": "231-499-0020",
        "authorized_official_credential": "LMSW"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "nadine@connectivecounselingtc.com",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "800 Cottageview Dr Ste 1072",
            "city": "Traverse City",
            "state": "MI",
            "country_code": "US",
            "postal_code": "496842322",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Amy Coneset, PT
• Jacqueline Marie Conger, LPC
• Richard Albert Conley, D.C.
• Marilyn Eileen Conlon, M.D.,
• Patricia Anne Conlon, NURSE PRACTITIONER
• Eric Connick, OD
• Susan Connor-Herrera, LMSW
• Kathy Connor
• Clifford Dean Conrad Jr., LPC
• Constance Baab, PHD, LMSW, PLLC

• Mental Health Clinic/Center (Including Community Mental Health Center) in Traverse City, MI
• Providers in Traverse City, MI by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2021; 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.