Tiffany Renee Brigolin
Individual provider Active NPI Professional Counselor · Utica, MI
NPI 1447718648 · NPPES record last updated Mar 6, 2019
Key facts
- NPI
- 1447718648
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Professional Counselor 101YP2500X
- License
- 6401017175 (MI)
- Practice address
- 11111 Hall Rd Ste 303
Utica, MI 48317-5726 - Phone
- (586) 997-3153
- NPI assigned
- Mar 6, 2019
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Mental Health Counselor
- Education
- Other, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Wentworth and Associates PC
Practice addresses (Care Compare)
11111 Hall Rd
Suite 300
Utica, MI 48317-5726
Phone (586) 997-3153
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240123003583 | MI | Practitioner - Mental Health Counselor | 4880046010 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6401017175 | MI | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wentworth and Associates PC | Current |
Accepting new patients |
Locations
11111 Hall Rd
Ste 303
Utica, MI 48317
Phone (586) 739-0902
11111 Hall Rd
Ste 300
Utica, MI 48317
Phone (586) 323-2181
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 6401017175 | MI | Yes |
Addresses
Primary practice location
11111 Hall Rd Ste 303
Utica, MI 48317-5726
Mailing address
2832 Walmsley Circle Dr
Lake Orion, MI 48360-1640
Phone (248) 766-7544
Other providers in Utica, MI
- Laurel J. Blume
- Melina A Bologna
- Sharon Lee Boyer
- David William Brege
- Brian J Donlon D D S P C
- Brookdale Senior Living Communities, Inc.
- Brookdale Senior Living Communities, Inc.
- Frances Rose Brown
- Danh M Bui
- Tracey Cantalupo
All providers in Utica, MI · Professional Counselor in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 6, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.