Active NPI
Michael Washburn, M.M., M.A., CSAT-C
- Professional Counselor
- Utica, MI
National Provider Identifier
1205238201
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 6401014327
- Practice address
- 11111 Hall Rd
Suite 300
Utica, MI 48317-5711 - Phone
- (586) 997-3153
- NPI assigned
- Sep 22, 2014
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 6401014327 | MI | Primary |
Addresses
Primary practice location
11111 Hall Rd
Suite 300
Utica, MI 48317-5711
Mailing address
20505 Milburn St
Livonia, MI 48152-1619
Phone (586) 215-9564
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6401014327 | MI | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1411344000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1411344000000",
"number": "1205238201",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "20505 MILBURN ST",
"city": "LIVONIA",
"state": "MI",
"postal_code": "481521619",
"telephone_number": "586-215-9564"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11111 HALL RD",
"address_2": "SUITE 300",
"city": "UTICA",
"state": "MI",
"postal_code": "483175711",
"telephone_number": "586-997-3153"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WASHBURN",
"first_name": "MICHAEL",
"credential": "M.M., M.A., CSAT-C",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2014-09-22",
"last_updated": "2014-09-22",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "MI",
"license": "6401014327",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Utica, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.