Active NPI
Carolyn Joyce Macomber, LPC
- Professional Counselor
- Niles, MI
National Provider Identifier
1063822666
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 6401013902
- Practice address
- 1011 Broadway St Ste 10
Niles, MI 49120-2762 - Phone
- (269) 485-1505
- NPI assigned
- May 5, 2014
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | 6401013902 | MI | |
| Professional Counselor | 101YP2500X | 6401013902 | MI | Primary |
Addresses
Primary practice location
1011 Broadway St Ste 10
Niles, MI 49120-2762
Mailing address
1011 Broadway St Ste10
Niles, MI 49120-2762
Phone (269) 845-1505
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6401013902 | MI | MD | Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1399248000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1502150400000",
"number": "1063822666",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1011 BROADWAY ST STE10",
"city": "NILES",
"state": "MI",
"postal_code": "491202762",
"telephone_number": "269-845-1505"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1011 BROADWAY ST STE 10",
"city": "NILES",
"state": "MI",
"postal_code": "491202762",
"telephone_number": "269-485-1505"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MACOMBER",
"first_name": "CAROLYN",
"middle_name": "JOYCE",
"name_prefix": "Miss",
"credential": "LPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-05-05",
"last_updated": "2017-08-08",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "MI",
"license": "6401013902",
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "MI",
"license": "6401013902",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Niles, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.