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12TH AVENUE SERVICES LLC
NPI 1023879186
Counselor - Mental Health in Clarkston, MI

Active since January 17, 2024
5541 WARBLER DR, CLARKSTON, MI 48346(248) 795-5253(248) 928-5350 Get Directions Write a Review

NPPES record last updated: January 17, 2024. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About 12th Avenue Services Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

12TH AVENUE SERVICES LLC (NPI 1023879186) is a healthcare organization registered as a mental health in Clarkston, Michigan and active in the NPI registry since January 2024. The organization lists Abigail Leigh Blackshire, Chief Executive Officer, as its authorized official.

NPPES Registry Identity

NPI1023879186
Entity TypeOrganization
Primary Taxonomy101YM0800X
Legal Business Name12TH AVENUE SERVICES LLC
Location Address5541 WARBLER DRClarkston, MI 48346-2965
Mailing Address5541 Warbler DrClarkston, MI 48346-2965 · (248) 795-5253 · Fax (248) 928-5350
Phone(248) 795-5253
Fax(248) 928-5350
Organization SubpartNo
Authorized OfficialAbigail Leigh BlackshireChief Executive Officer · (248) 795-5253
Enumeration DateJanuary 17, 2024
NPPES CertifiedJanuary 17, 2024
✔ NPI 1023879186 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
5541 WARBLER DR, Clarkston, MI 48346
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Other Identifiers 1

Medicaid1285110288AK

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Care Network of Michigan, Blue Cross Blue Shield of Michigan Mutual Insurance Company.Insurance ›

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is 12th Avenue Services LLC's NPI number?

The NPI number for 12th Avenue Services LLC is 1023879186. It was assigned to this organization in the NPPES registry on January 17, 2024.

Where is 12th Avenue Services LLC located?

12th Avenue Services LLC is located at 5541 Warbler Dr, Clarkston, MI 48346. The listed phone number is (248) 795-5253.

What is 12th Avenue Services LLC's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

What insurance does 12th Avenue Services LLC accept?

Health plans from Blue Care Network of Michigan and Blue Cross Blue Shield of Michigan Mutual Insurance Company list 12th Avenue Services LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for 12th Avenue Services LLC was last updated on January 17, 2024. NPI Profile syncs with the weekly NPPES data releases published by CMS.