Michael James Cebulski, CPRC,CADC

Key facts

NPI: 1972130177
Entity type: Individual (NPI type 1)
Primary specialty: Addiction (Substance Use Disorder) Counselor 101YA0400X
Practice address: 101 M 66 N
Charlevoix, MI 49720-9338
Phone: (231) 547-1144
Fax: (231) 547-4970
NPI assigned: Mar 26, 2020
Sex: Male
Sole proprietor: No

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.

Bay Area Substance Education Services Mental Health Counselor · Charlevoix, MI · NPI 1790053270

NPD ADDICTION (SUBSTANCE USE DISORDER)

Medicare participation

Medicare fee-for-service enrollment: Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD): No

Practice roles

Organization	Specialty	Status	New patients
Bay Area Substance Education Services	Addiction (Substance Use Disorder)	Current since Mar 1, 2020	Accepting new patients

Locations

101 M 66 N
Charlevoix, MI 49720
Phone (231) 547-1144

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Addiction (Substance Use Disorder) Counselor	101YA0400X		MI	Yes

Addresses

Primary practice location

101 M 66 N
Charlevoix, MI 49720-9338

Mailing address

101 M 66 N
Charlevoix, MI 49720-9338
Phone (231) 547-1144

Other identifiers

Identifier	Type	State	Issuer
20151209439760	Medicaid	MI

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jun 15, 2023.

{
    "created_epoch": "1585180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686787200000",
    "number": "1972130177",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 M 66 N",
            "city": "CHARLEVOIX",
            "state": "MI",
            "postal_code": "497209338",
            "telephone_number": "231-547-1144",
            "fax_number": "231-547-4970"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 M 66 N",
            "city": "CHARLEVOIX",
            "state": "MI",
            "postal_code": "497209338",
            "telephone_number": "231-547-1144",
            "fax_number": "231-547-4970"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CEBULSKI",
        "first_name": "MICHAEL",
        "middle_name": "JAMES",
        "credential": "CPRC,CADC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-03-26",
        "last_updated": "2023-06-15",
        "certification_date": "2023-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "20151209439760",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlevoix, MI

All providers in Charlevoix, MI · Addiction (Substance Use Disorder) Counselor in Michigan

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 15, 2023. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.