Active NPI
Carly Bammer
- Counselor
- Michigan Center, MI
National Provider Identifier
1295495067
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- 6451021988
- Practice address
- 4228 Page Ave
Michigan Center, MI 49254-1072 - Phone
- (517) 244-6050
- NPI assigned
- Dec 21, 2021
- Last updated
- May 26, 2023
- 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 |
|---|---|---|---|---|
| Counselor | 101Y00000X | 6451021988 | MI | Primary |
Addresses
Primary practice location
4228 Page Ave
Michigan Center, MI 49254-1072
Mailing address
4228 Page Ave
Michigan Center, MI 49254-1072
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, 2017
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
885 Penniman Ave
Unit 5425
Plymouth, MI 48170-7729
PO Box
Suite 873
Grass Lake, MI 49240-0873
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6451021988 | MI | MD | Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lifespring Counseling Services | Counselor | Current | Accepting new patients |
Organizations & group practices 1
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.
-
- Counselor
- Jackson, MI
- NPI 1679077242
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1640044800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1685059200000",
"number": "1295495067",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4228 PAGE AVE",
"city": "MICHIGAN CENTER",
"state": "MI",
"postal_code": "492541072"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4228 PAGE AVE",
"city": "MICHIGAN CENTER",
"state": "MI",
"postal_code": "492541072",
"telephone_number": "517-244-6050"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BAMMER",
"first_name": "CARLY",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-12-21",
"last_updated": "2023-05-26",
"certification_date": "2023-05-26",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "MI",
"license": "6451021988",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Michigan Center, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2023; 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.