Active NPI
Joelle Lyn Drader, M.D., M.A., L.P.C.
- Professional Counselor
- Petoskey, MI
National Provider Identifier
1164600730
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 6401013059
- Practice address
- 413 Waukazoo Ave
Petoskey, MI 49770-2619 - Phone
- (231) 622-5156
- NPI assigned
- Feb 6, 2008
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Physician | 208D00000X | 4301068311 | MI | |
| Professional Counselor | 101YP2500X | 6401013059 | MI | Primary |
Addresses
Primary practice location
413 Waukazoo Ave
Petoskey, MI 49770-2619
Mailing address
413 Waukazoo Ave
Petoskey, MI 49770-2619
Phone (231) 622-5156
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
- Credentials
- Master of Arts, Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6401013059 | MI | MD | Professional Counselor |
| 4301068311 | MI | MD | General Practice Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1202256000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1447459200000",
"number": "1164600730",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "413 WAUKAZOO AVE",
"city": "PETOSKEY",
"state": "MI",
"postal_code": "497702619",
"telephone_number": "231-622-5156"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "413 WAUKAZOO AVE",
"city": "PETOSKEY",
"state": "MI",
"postal_code": "497702619",
"telephone_number": "231-622-5156"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DRADER",
"first_name": "JOELLE",
"middle_name": "LYN",
"credential": "M.D., M.A., L.P.C.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-02-06",
"last_updated": "2015-11-14",
"status": "A"
},
"taxonomies": [
{
"code": "208D00000X",
"taxonomy_group": "",
"desc": "General Practice",
"state": "MI",
"license": "4301068311",
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "MI",
"license": "6401013059",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Petoskey, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.