Individual provider Active NPI

Donna Marie Widman, MA, LPC

  • Mental Health Counselor
  • Troy, MI
National Provider Identifier
1023355211
Registry record updated Jun 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
6401011034 Issued in MI
Practice address
700 E Big Beaver Rd Ste D
Troy, MI 48083-1435
Phone
(248) 817-6629
Fax
(248) 817-6694
NPI assigned
Jan 9, 2013
Last updated
Jun 12, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 12, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 6401011034 MI Primary

Addresses

Primary practice location

700 E Big Beaver Rd Ste D
Troy, MI 48083-1435

Mailing address

700 E Big Beaver Rd Ste D
Troy, MI 48083-1435
Phone (248) 817-6629

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20231206003393 MI Practitioner - Mental Health Counselor 1052730389 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Insight Counseling Center of Troy, LLCGroup PAC ID 0143649475, 3 clinicians

Practice addresses (Care Compare)

700 E Big Beaver Rd
Suite D
Troy, MI 48083-1435
Phone (248) 817-6629

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

Practice roles

OrganizationSpecialtyStatusNew patients
Insight Counseling Center of Troy, LLC. Current Accepting new patients
Insight Counseling Center of Troy, LLC Counselor CurrentSince Jan 1, 2020 Accepting new patients

Locations

650 E Big Beaver Rd
Ste B
Troy, MI 48083
Phone (248) 770-2285

700 E Big Beaver Rd
Ste D
Troy, MI 48083
Phone (248) 417-3783

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1357689600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686528000000",
    "number": "1023355211",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 E BIG BEAVER RD STE D",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480831435",
            "telephone_number": "248-817-6629",
            "fax_number": "248-817-6694"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 E BIG BEAVER RD STE D",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480831435",
            "telephone_number": "248-817-6629",
            "fax_number": "248-817-6694"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIDMAN",
        "first_name": "DONNA",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "MA, LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-01-09",
        "last_updated": "2023-06-12",
        "certification_date": "2023-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MI",
            "license": "6401011034",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Troy, MI

Sources for this page

Verify at the official NPI Registry.