Individual provider Active NPI

Julie Staples, MA, LPC

  • Counselor
  • Dearborn, MI
National Provider Identifier
1386669091
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
6401007410 Issued in MI
Practice address
5111 Auto Club Dr
#120
Dearborn, MI 48126-2749
Phone
(313) 529-0735
Fax
(313) 583-0751
NPI assigned
Jul 13, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X 6401007410 MI Primary

Addresses

Primary practice location

5111 Auto Club Dr
#120
Dearborn, MI 48126-2749

Mailing address

28000 Dequindre Rd
Warren, MI 48092-2468
Phone (586) 753-0405

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231222001576 MI Practitioner - Mental Health Counselor 0749630374 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Joel L Young MD PCGroup PAC ID 3971575929, 59 clinicians

Practice addresses (Care Compare)

441 S Livernois Rd
100 Rochester Center for Behavioral Medicin
Rochester HLS, MI 48307-2585
Phone (248) 608-8800

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

Practice roles

OrganizationSpecialtyStatusNew patients
Joel L. Young, M.D., P.C. CurrentSince Jan 1, 2024 Accepting new patients

Locations

441 S Livernois Rd
Ste 100
Rochester Hills, MI 48307
Phone (248) 608-8800

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.

NPI Registry JSON

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

{
    "created_epoch": "1152748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1386669091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28000 DEQUINDRE RD",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480922468",
            "telephone_number": "586-753-0405",
            "fax_number": "586-753-0404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5111 AUTO CLUB DR",
            "address_2": "#120",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481262749",
            "telephone_number": "313-529-0735",
            "fax_number": "313-583-0751"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STAPLES",
        "first_name": "JULIE",
        "credential": "MA, LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "MI",
            "license": "6401007410",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dearborn, MI

Sources for this page

Verify at the official NPI Registry.