Individual provider Active NPI

Demi Anne Devenny, LPC

  • Professional Counselor
  • New Hudson, MI
National Provider Identifier
1154073781
Registry record updated Feb 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
6401223969 Issued in MI
Practice address
53435 Grand River Ave
New Hudson, MI 48165-8521
Phone
(810) 494-7180
Fax
(248) 692-4936
NPI assigned
Jan 25, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 6401223969 MI Primary

Addresses

Primary practice location

53435 Grand River Ave
New Hudson, MI 48165-8521

Mailing address

1100 Torrey Rd Ste 100
Fenton, MI 48430-3327
Phone (810) 494-7180

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
I20240320003559 MI Practitioner - Mental Health Counselor 2466899844 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Downriver Mental Health Clinic PCGroup PAC ID 7911995139, 289 clinicians

Practice addresses (Care Compare)

53435 Grand River Ave
New Hudson, MI 48165-8521
Phone (810) 494-7180

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6401223969MIMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Downriver Mental Health Clinic PC CurrentSince Mar 18, 2024 Accepting new patients
Downriver Mental Health Clinic PC Professional CurrentSince Mar 18, 2024 Accepting new patients

Locations

1400 Abbot Rd
Ste 400
East Lansing, MI 48823
Phone (810) 220-2787

1100 Torrey Rd
Ste 100
Fenton, MI 48430
Phone 8104947180106

2628 S Milford Rd
Highland, MI 48357
Phone (248) 529-3049

53435 Grand River Ave
New Hudson, MI 48165
Phone (517) 492-0517

Interoperability endpoints

  • Direct secure messaging: lifestancehealth.demiroselle@150339.advancedmd-direct.com

Organizations & group practices 2

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": "1643068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708300800000",
    "number": "1154073781",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 TORREY RD STE 100",
            "city": "FENTON",
            "state": "MI",
            "postal_code": "484303327",
            "telephone_number": "810-494-7180",
            "fax_number": "248-692-4936"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "53435 GRAND RIVER AVE",
            "city": "NEW HUDSON",
            "state": "MI",
            "postal_code": "481658521",
            "telephone_number": "810-494-7180",
            "fax_number": "248-692-4936"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEVENNY",
        "first_name": "DEMI",
        "middle_name": "ANNE",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-25",
        "last_updated": "2024-02-19",
        "certification_date": "2024-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MI",
            "license": "6401223969",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Hudson, MI

Sources for this page

Verify at the official NPI Registry.