Individual provider Active NPI

Genny Lynn Luppino, LPC

  • Counselor
  • Trenton, MI
National Provider Identifier
1124549514
Registry record updated Mar 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
6401015177 Issued in MI
Practice address
2360 W Jefferson Ave Ste 102
Trenton, MI 48183-2706
Phone
(734) 365-6976
Fax
(734) 283-7287
NPI assigned
Jul 6, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X 6401015177 MI Primary

Addresses

Primary practice location

2360 W Jefferson Ave Ste 102
Trenton, MI 48183-2706

Mailing address

2360 W Jefferson Ave Ste 102
Trenton, MI 48183-2706
Phone (734) 365-6976

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

LicenseStateTypeSpecialty
6401015177MIMDCounselor

Practice roles

OrganizationSpecialtyStatusNew patients
Awakened Mind Counseling CurrentSince Jan 1, 2023 Accepting new patients

Locations

2360 W Jefferson Ave
Ste 102
Trenton, MI 48183
Phone (734) 365-6976

100 Maple St
Ste 215
Wyandotte, MI 48192
Phone (734) 288-8161

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1499299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678406400000",
    "number": "1124549514",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2360 W JEFFERSON AVE STE 102",
            "city": "TRENTON",
            "state": "MI",
            "postal_code": "481832706",
            "telephone_number": "734-365-6976",
            "fax_number": "734-283-7287"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2360 W JEFFERSON AVE STE 102",
            "city": "TRENTON",
            "state": "MI",
            "postal_code": "481832706",
            "telephone_number": "734-365-6976",
            "fax_number": "734-283-7287"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUPPINO",
        "first_name": "GENNY",
        "middle_name": "LYNN",
        "name_prefix": "Ms.",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-06",
        "last_updated": "2023-03-10",
        "certification_date": "2023-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "MI",
            "license": "6401015177",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Trenton, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2023; 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.