Individual provider Active NPI

Lori Ann Mello, LPC

  • Counselor
  • Ferndale, MI
National Provider Identifier
1124699939
Registry record updated Jul 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
6401005780 Issued in MI
Practice address
853 Wordsworth St
Ferndale, MI 48220-2554
Phone
(248) 854-4529
NPI assigned
Jul 3, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 25, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101Y00000X 6401005780 MI Primary

Addresses

Primary practice location

853 Wordsworth St
Ferndale, MI 48220-2554

Mailing address

853 Wordsworth St
Ferndale, MI 48220-2554
Phone (248) 854-4529

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231127000697 MI Practitioner - Mental Health Counselor 0648628073 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6401005780MIMDCounselor

Practice roles

OrganizationSpecialtyStatusNew patients
Oakland Psychological Clinic, P.C. Single Specialty Current Accepting new patients
Optum Behavioral Care of Colorado, P.C. Single Specialty Current Accepting new patients
Optum Behavioral Care of Colorado, P.C. CurrentSince Apr 8, 2024 Accepting new patients
Optum Behavioral Care of Colorado, P.C. CurrentSince Apr 8, 2024 Accepting new patients

Locations

2550 S Telegraph Rd
Ste 250
Bloomfld Hls, MI 48302
Phone (248) 322-0001

16664 15 Mile Rd
Fraser, MI 48026
Phone (586) 294-3030

33300 5 Mile Rd
Ste 208
Livonia, MI 48154
Phone (734) 522-0280

17352 W 12 Mile Rd
Ste 100
Southfield, MI 48076
Phone (248) 559-0730

Interoperability endpoints

  • Direct secure messaging: lori.mello.1@28621.direct.athenahealth.com

Organizations & group practices 4

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": "1625270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690243200000",
    "number": "1124699939",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "853 WORDSWORTH ST",
            "city": "FERNDALE",
            "state": "MI",
            "postal_code": "482202554",
            "telephone_number": "248-854-4529"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "853 WORDSWORTH ST",
            "city": "FERNDALE",
            "state": "MI",
            "postal_code": "482202554",
            "telephone_number": "248-854-4529"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MELLO",
        "first_name": "LORI",
        "middle_name": "ANN",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-07-03",
        "last_updated": "2023-07-25",
        "certification_date": "2023-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor",
            "state": "MI",
            "license": "6401005780",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ferndale, MI

Sources for this page

Verify at the official NPI Registry.