Tricia Eagen, LPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

6401223026 Issued in MI

Practice address

104 W 4TH St Ste 204
Royal Oak, MI 48067-3803

Phone

(458) 215-1356

NPI assigned

May 14, 2024

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Shura Eagen Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Inhabit Bodymind Therapy

  • Mental Health Counselor
  • Ypsilanti, MI
  • NPI 1508696303
  NPD

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

{
    "created_epoch": "1715644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715644800000",
    "number": "1093564809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1829 W STADIUM BLVD STE 300",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481037009",
            "telephone_number": "458-215-1356"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 W 4TH ST STE 204",
            "city": "ROYAL OAK",
            "state": "MI",
            "postal_code": "480673803",
            "telephone_number": "458-215-1356"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1829 W Stadium Blvd Ste 300",
            "address_purpose": "LOCATION",
            "city": "Ann Arbor",
            "state": "MI",
            "postal_code": "481037009",
            "country_code": "US",
            "telephone_number": "458-215-1356",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EAGEN",
        "first_name": "TRICIA",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-05-14",
        "last_updated": "2024-05-14",
        "certification_date": "2024-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MI",
            "license": "6401223026",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHURA",
            "last_name": "EAGEN",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Mental Health Counselor in Royal Oak, MI
• Providers in Royal Oak, MI by specialty
• Mental Health Counselor in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 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.