Active NPI
Nicole Walby, MALLPC
- Professional Counselor
- Clinton Township, MI
National Provider Identifier
1073764015
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 6401011068
- Practice address
- 42669 Garfield Rd
Clinton Township, MI 48038-5036 - Phone
- (586) 412-5321
- NPI assigned
- Oct 8, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 6401011068 | MI | Primary |
Addresses
Primary practice location
42669 Garfield Rd
Clinton Township, MI 48038-5036
Mailing address
12850 Fountain SQ
Suite 106
Davisburg, MI 48350-2552
Phone (586) 412-5321
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 |
|---|---|---|---|
| 6401011068 | MI | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1223424000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1223424000000",
"number": "1073764015",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12850 FOUNTAIN SQ",
"address_2": "SUITE 106",
"city": "DAVISBURG",
"state": "MI",
"postal_code": "483502552",
"telephone_number": "586-412-5321"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "42669 GARFIELD RD",
"city": "CLINTON TOWNSHIP",
"state": "MI",
"postal_code": "480385036",
"telephone_number": "586-412-5321"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALBY",
"first_name": "NICOLE",
"credential": "MALLPC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-10-08",
"last_updated": "2008-10-08",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "MI",
"license": "6401011068",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Clinton Township, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.