Organization Active NPI

Roam Well, LLC

  • Professional Counselor
  • Royal Oak, MI
National Provider Identifier
1366124265
Registry record updated Aug 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
Legal business name
ROAM WELL, LLC
Practice address
1320 N Campbell Rd Ste 22
Royal Oak, MI 48067-1555
Phone
(248) 266-5616
Fax
(219) 200-3367
NPI assigned
Aug 1, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2023

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

Authorized official

Name
Julie Middlin, MA, LPC, NCCNPI 1417004862
Title
Owner
Phone
(248) 266-5616

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YP2500X Primary

Addresses

Primary practice location

1320 N Campbell Rd Ste 22
Royal Oak, MI 48067-1555

Mailing address

1320 N Campbell Rd Ste 22
Royal Oak, MI 48067-1555
Phone (248) 266-5616

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240424001225 MI Part B Supplier - Clinic/Group Practice 9032559026 Receives reassigned benefits from 1 practitioner
Practice locations: Royal Oak, MI

National Provider Directory

National Provider Directory

Locations

1320 N Campbell Rd
Ste 22
Royal Oak, MI 48067
Phone (248) 266-5616

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1690848000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1690848000000",
    "number": "1366124265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1320 N CAMPBELL RD STE 22",
            "city": "ROYAL OAK",
            "state": "MI",
            "postal_code": "480671555",
            "telephone_number": "248-266-5616",
            "fax_number": "219-200-3367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1320 N CAMPBELL RD STE 22",
            "city": "ROYAL OAK",
            "state": "MI",
            "postal_code": "480671555",
            "telephone_number": "248-266-5616",
            "fax_number": "219-200-3367"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROAM WELL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-08-01",
        "last_updated": "2023-08-01",
        "certification_date": "2023-08-01",
        "status": "A",
        "authorized_official_last_name": "MIDDLIN",
        "authorized_official_first_name": "JULIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "248-266-5616",
        "authorized_official_credential": "MA, LPC, NCC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Royal Oak, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.