Individual provider Active NPI

Madonna Rae Judge, LLPC

  • Counselor
  • Plymouth, MI
National Provider Identifier
1407504814
Registry record updated Jul 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
6451019574 Issued in MI
Practice address
9409 N Haggerty Rd
Plymouth, MI 48170-4696
Phone
(734) 559-3540
NPI assigned
Mar 15, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 6451019574 MI
Counselor 101Y00000X 6451019574 MI Primary

Addresses

Primary practice location

9409 N Haggerty Rd
Plymouth, MI 48170-4696

Mailing address

239 Hutton St Apt 4
Northville, MI 48167-1246
Phone (313) 820-0626

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
I20241112003205 MI Practitioner - Mental Health Counselor 8224562327 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Transformational Services LLCGroup PAC ID 8820219322, 34 clinicians

Practice addresses (Care Compare)

9409 N Haggerty Rd
Plymouth, MI 48170-4696
Phone (734) 559-3540

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6451019574MIMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Transformational Services LLC CurrentSince Oct 24, 2024 Accepting new patients

Locations

9409 N Haggerty Rd
Plymouth, MI 48170
Phone (734) 231-3933

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": "1647302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689638400000",
    "number": "1407504814",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "239 HUTTON ST APT 4",
            "city": "NORTHVILLE",
            "state": "MI",
            "postal_code": "481671246",
            "telephone_number": "313-820-0626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9409 N HAGGERTY RD",
            "city": "PLYMOUTH",
            "state": "MI",
            "postal_code": "481704696",
            "telephone_number": "734-559-3540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JUDGE",
        "first_name": "MADONNA",
        "middle_name": "RAE",
        "credential": "LLPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-15",
        "last_updated": "2023-07-18",
        "certification_date": "2023-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MI",
            "license": "6451019574",
            "primary": false
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "MI",
            "license": "6451019574",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plymouth, MI

Sources for this page

Verify at the official NPI Registry.