Wade Randolph Stitt, M.A.C., L.P.C.
Individual provider Active NPI Mental Health Counselor · Marne, MI
NPI 1013139872 · NPPES record last updated Feb 21, 2024
Key facts
- NPI
- 1013139872
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Mental Health Counselor 101YM0800X
- License
- 6401009358 (MI)
- Practice address
- 15146 16TH Ave
Marne, MI 49435-9605 - Phone
- (844) 776-9651
- NPI assigned
- May 2, 2007
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Mental Health Counselor
- Education
- Other, 2013
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Great Lakes Wellness Counseling LLC
Practice addresses (Care Compare)
1348 Baldwin St
Jenison, MI 49428-8937
Phone (616) 202-1910
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20251205000939 | MI | Practitioner - Mental Health Counselor | 3375036544 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6401009358 | MI | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Great Lakes Wellness Counseling LLC | Current |
Accepting new patients |
Locations
1348 Baldwin St
Jenison, MI 49428
Phone (616) 202-1910
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 6401009358 | MI | Yes |
Addresses
Primary practice location
15146 16TH Ave
Marne, MI 49435-9605
Mailing address
15146 16TH Ave
Marne, MI 49435-9605
Phone (844) 776-9651
Other providers in Marne, MI
- Shining Shield Medical Group, PC
- Bibhas Singla
- Sophia Noel Smith
- Angela D Staal
- Tessa V Sterling
- Alexis Renee Sumner
- Margaret Kimberley Van Hooser
- Mary Carol Vander Wal
- Robin Nicole Zody
- Victoria Zuniga
All providers in Marne, MI · Mental Health 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 Feb 21, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.