Individual provider Active NPI

Sharon Nell Rudy, LPC

  • Professional Counselor
  • Troy, MI
National Provider Identifier
1396868063
Registry record updated Mar 13, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
6401007089 Issued in MI
Practice address
1080 Kirts Blvd
Suite 100
Troy, MI 48084-4881
Phone
(248) 225-6297
NPI assigned
Apr 9, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 13, 2009

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 6401007089 MI Primary
Marriage & Family Therapist 106H00000X 4101006259 MI

Addresses

Primary practice location

1080 Kirts Blvd
Suite 100
Troy, MI 48084-4881

Mailing address

3245 McCormick Dr
Waterford, MI 48328-1641
Phone (248) 225-6297

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
I20241104000365 MI Practitioner - Mental Health Counselor 7618400318 Practice locations: Troy, MI

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

888 W Big Beaver Rd
Suite 780
Troy, MI 48084-4745
Phone (248) 225-6297

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6401007089MIMDProfessional Counselor
4101006259MIMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Hartland Individual and Family Services LLC PastSince Apr 1, 2021 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1176076800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1236902400000",
    "number": "1396868063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3245 MCCORMICK DR",
            "city": "WATERFORD",
            "state": "MI",
            "postal_code": "483281641",
            "telephone_number": "248-225-6297"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1080 KIRTS BLVD",
            "address_2": "SUITE 100",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480844881",
            "telephone_number": "248-225-6297"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUDY",
        "first_name": "SHARON",
        "middle_name": "NELL",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-09",
        "last_updated": "2009-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MI",
            "license": "6401007089",
            "primary": true
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MI",
            "license": "4101006259",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Troy, MI

Sources for this page

Verify at the official NPI Registry.