Individual provider Active NPI

Michelle Lee Macinnis, LLPC, MS

  • Professional Counselor
  • Plymouth, MI
National Provider Identifier
1053127597
Registry record updated Dec 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
6451024061 Issued in MI
Practice address
41100 Plymouth Rd Ste 110
Plymouth, MI 48170-3895
Phone
(734) 927-1201
NPI assigned
Dec 9, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 9, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YP2500X 6451024061 MI Primary

Addresses

Primary practice location

41100 Plymouth Rd Ste 110
Plymouth, MI 48170-3895

Mailing address

46540 Bartlett Dr
Canton, MI 48187-1517
Phone (313) 282-0384

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
6451024061MIMDProfessional Counselor

NPI Registry JSON

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

{
    "created_epoch": "1733702400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733702400000",
    "number": "1053127597",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "46540 BARTLETT DR",
            "city": "CANTON",
            "state": "MI",
            "postal_code": "481871517",
            "telephone_number": "313-282-0384"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "41100 PLYMOUTH RD STE 110",
            "city": "PLYMOUTH",
            "state": "MI",
            "postal_code": "481703895",
            "telephone_number": "734-927-1201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACINNIS",
        "first_name": "MICHELLE",
        "middle_name": "LEE",
        "credential": "LLPC, MS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-12-09",
        "last_updated": "2024-12-09",
        "certification_date": "2024-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "state": "MI",
            "license": "6451024061",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plymouth, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.