CARL CROCKETT (NPI# 1912025586) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1912025586 |
Entity Type | Individual |
Full Name | CARL CROCKETT |
Credential | M.A |
Practice Address |
4875 Coplin Administration Detroit MI 48125-2192 |
Practice Telephone | 3138221148 |
Practice Fax Number | 3138221157 |
Mailing Telephone | 3138221148 |
Mailing Fax Number | 3138221157 |
Enumeration Date | 2007-03-26 |
Last Update Date | 2007-07-08 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
MA | MI | Behavioral Health & Social Service Providers |
Street Address |
4875 COPLIN ADMINISTRATION |
City | DETROIT |
State | MI |
Zip Code | 48125-2192 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1033655618 | Marquise Kirk | Counselor | 4875 Coplin, Detroit, MI 48215-2192 | 2017-01-06 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1063071637 | Smart Rx LLC | Pharmacy | 25464 Van Born Rd, Dearborn Heights, MI 48125 | 2019-06-07 |
1558811331 | Jacquelyn Elyoussef | Technician, Other | 3930 Academy St, Dearborn Heights, MI 48125 | 2016-10-05 |
1386856375 | Amerigard Development Corporation | Family Medicine | 23850 Van Born Road, Dearborn Heights, MI 48125 | 2007-05-04 |
1922140490 | Marie C Petricca | Social Worker | 20382 Van Born Road, Catholic Social Services of Wayne County, Dearborn Heights, MI 48125 | 2007-02-13 |
1528025871 | David L Cooley | Family Medicine | 3902 Monroe, Dearborn Heights, MI 48125 | 2006-04-28 |
1013998251 | Masha-moss Inc | Pharmacy | 4245 S Beech Daly Rd, Dearborn Heights, MI 48125 | 2005-11-06 |
1033639109 | Clinic Rx 2 LLC | Pharmacy | 23850 Van Born Rd, Dearborn Heights, MI 48125 | 2017-06-21 |
1932639176 | Olivia J. Furnas | Midwife | 18101 Oakwood Blvd, Dearborn, MI 48125 | 2017-06-19 |
1083099303 | Holistic Healer Health Coaching LLC | Nutritionist | 3998 Clippert St, Dearborn Heights, MI 48125 | 2015-07-28 |
1396255915 | Lillian Drushelia Herzberg | Registered Nurse | 26827 Annapolis St, Dearborn Hts, MI 48125-1201 | 2017-10-10 |
Find all providers in zip 48125 |
Taxonomy Code | 101YA0400X |
Grouping | Behavioral Health & Social Service Providers |
Classification | Counselor |
Specialization | Addiction (Substance Use Disorder) |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1386251841 | Diversified Community Services | Counselor | 10301 W 7 Mile Rd, Detroit, MI 48221-1962 | 2020-09-29 |
1750907853 | Ronnie Stephen | Counselor | 15025 Fenkell St, Detroit, MI 48227-2647 | 2020-06-24 |
1144860552 | Allen Hugh Warrick IIi | Counselor | 9605 Grand River Ave # A, Detroit, MI 48204-2139 | 2020-01-14 |
1396309878 | Darnesha Coy | Counselor | 17870 Dresden St, Detroit, MI 48205-3138 | 2019-04-30 |
1518438746 | Curron Thomas | Counselor | 16850 Wyoming St, Apartment 328, Detroit, MI 48221-3415 | 2018-12-16 |
1861962094 | Reid Talley | Counselor | 12010 Elmhurst, Detroit, MI 48206 | 2018-11-30 |
1205304359 | Life Challenge of Southeastern Michigan | Counselor | 17667 Pierson St, Detroit, MI 48219-2520 | 2018-11-07 |
1598233892 | Michigan Employment & Training Plus | Counselor | 6522 Piedmont St, Detroit, MI 48228-4950 | 2018-11-05 |
1821588773 | Avery Brown Jr. | Counselor | 8333 Townsend St, Detroit, MI 48213-2331 | 2018-05-16 |
1538669304 | Helping Hands Community Centers 1 | Counselor | 2434 Chicago Blvd, Detroit, MI 48206-1741 | 2018-02-17 |
Find all providers in DETROIT |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.