Wade Randolph Stitt, M.A.C., L.P.C.

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

6401009358 Issued in MI

Practice address

15146 16TH Ave
Marne, MI 49435-9605

Phone

(844) 776-9651

NPI assigned

May 2, 2007

Last updated

Feb 21, 2024By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Great Lakes Wellness Counseling LLCGroup PAC ID 8527551811, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Great Lakes Wellness Counseling LLC

  • Professional Counselor
  • Grandville, MI
  • NPI 1437651916
  Medicare reassignment Care Compare group NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1178064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708473600000",
    "number": "1013139872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15146 16TH AVE",
            "city": "MARNE",
            "state": "MI",
            "postal_code": "494359605",
            "telephone_number": "844-776-9651"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15146 16TH AVE",
            "city": "MARNE",
            "state": "MI",
            "postal_code": "494359605",
            "telephone_number": "844-776-9651"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STITT",
        "first_name": "WADE",
        "middle_name": "RANDOLPH",
        "credential": "M.A.C., L.P.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-02",
        "last_updated": "2024-02-21",
        "certification_date": "2024-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MI",
            "license": "6401009358",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shining Shield Medical Group, PC
• Bibhas Singla, M.D.
• Sophia Noel Smith, MS RDN
• Angela D Staal, RN
• Tessa V Sterling, LCSW
• Alexis Renee Sumner, LPC
• Margaret Kimberley Van Hooser, LMSW
• Mary Carol Vander Wal, NP
• Robin Nicole Zody, PMHNP-BC
• Victoria Zuniga, MSN, RN, PMHNP-BC

• Mental Health Counselor in Marne, MI
• Providers in Marne, MI by specialty
• Mental Health Counselor in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.