Active NPI
Breanne Teresa Passalacqua, M.A.,LPC
- Professional Counselor
- Fenton, MI
National Provider Identifier
1275921629
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 6401225133
- Practice address
- 10291 Foley Rd
Fenton, MI 48430-9250 - Phone
- (810) 597-7293
- NPI assigned
- Jan 7, 2015
- Last updated
- Feb 15, 2026
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 6401225133 | MI | Primary |
Addresses
Primary practice location
10291 Foley Rd
Fenton, MI 48430-9250
Mailing address
10291 Foley Rd
Fenton, MI 48430-9250
Phone (810) 597-7293
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Mental Health Counselor
- Education
- Other, 2013
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
66 E Flagler St
Miami, FL 33130-1807
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6401225133 | MI | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Grow Healthcare Group PA | Professional | Current | Accepting new patients |
| Consumer Services, Inc. | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1420588800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1771113600000",
"number": "1275921629",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10291 FOLEY RD",
"city": "FENTON",
"state": "MI",
"postal_code": "484309250",
"telephone_number": "810-597-7293"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10291 FOLEY RD",
"city": "FENTON",
"state": "MI",
"postal_code": "484309250",
"telephone_number": "810-597-7293"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PASSALACQUA",
"first_name": "BREANNE",
"middle_name": "TERESA",
"name_prefix": "Mrs.",
"credential": "M.A.,LPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-01-07",
"last_updated": "2026-02-15",
"certification_date": "2026-02-15",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "MI",
"license": "6401225133",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fenton, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.