Healthcare Provider Details

I. General information

NPI: 1609536135
Provider Name (Legal Business Name): CROSSLEY WELLNESS CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/24/2021
Last Update Date: 10/16/2025
Certification Date: 10/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5154 MILLER RD STE I
FLINT MI
48507-1069
US

IV. Provider business mailing address

5154 MILLER RD STE I
FLINT MI
48507-1069
US

V. Phone/Fax

Practice location:
  • Phone: 810-447-9736
  • Fax:
Mailing address:
  • Phone: 810-228-3164
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: TAYLOR MARIE CROSSLEY
Title or Position: PSYCHIATRIC NURSE PRACTITIONER
Credential:
Phone: 810-228-3164