Individual provider Active NPI

Marianna Jane Nunez, PHD, LPC

  • Professional Counselor
  • Hillsdale, MI
National Provider Identifier
1083851810
Registry record updated Feb 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
6401012160 Issued in MI
Practice address
11 E Carleton Rd
Hillsdale, MI 49242-1619
Phone
(517) 437-7100
Fax
(517) 437-7101
NPI assigned
Jan 15, 2009
Last updated
Feb 27, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X E5577 OH
Professional Counselor 101YP2500X 6401012160 MI Primary

Addresses

Primary practice location

11 E Carleton Rd
Hillsdale, MI 49242-1619

Mailing address

1615 Lamphere LN
Hillsdale, MI 49242-9283
Phone (517) 425-4507

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2005
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

2601 Jackson Ave
Suite 1133
Ann Arbor, MI 48103-3820

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
6401012160MIMDProfessional Counselor
E5577OHMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Brightside Medical of Michigan PC CurrentSince Feb 1, 2024 Accepting new patients

Locations

2261 Market St
San Francisco, CA 94114
Phone (213) 337-4615

2601 Jackson Ave
#1133
Ann Arbor, MI 48103

Organizations & group practices 1

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": "1231977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708992000000",
    "number": "1083851810",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1615 LAMPHERE LN",
            "city": "HILLSDALE",
            "state": "MI",
            "postal_code": "492429283",
            "telephone_number": "517-425-4507",
            "fax_number": "517-437-7101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 E CARLETON RD",
            "city": "HILLSDALE",
            "state": "MI",
            "postal_code": "492421619",
            "telephone_number": "517-437-7100",
            "fax_number": "517-437-7101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NUNEZ",
        "first_name": "MARIANNA",
        "middle_name": "JANE",
        "name_prefix": "Dr.",
        "credential": "PHD, LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-01-15",
        "last_updated": "2024-02-27",
        "certification_date": "2021-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OH",
            "license": "E5577",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MI",
            "license": "6401012160",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hillsdale, MI

Sources for this page

Verify at the official NPI Registry.