Active NPI
Ambrosia Nottage, LPC,CRC
- Professional Counselor
- Southfield, MI
National Provider Identifier
1457616609
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 6401012758
- Practice address
- 29201 Telegraph Rd Ste 550
Southfield, MI 48034-7664 - Phone
- (517) 492-0784
- NPI assigned
- Jul 12, 2012
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 6401012758 | MI | Primary |
Addresses
Primary practice location
29201 Telegraph Rd Ste 550
Southfield, MI 48034-7664
Mailing address
22550 Hall Rd
Clinton TWP, MI 48036-1189
Phone (586) 850-3011
Other practice location 1
22550 Hall Rd
Clinton Township, MI 48036-1189
Phone (313) 550-3433
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Mental Health Counselor
- Education
- Other, 2011
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
4800 N Scottsdale Rd
Scottsdale, AZ 85251-7630
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6401012758 | MI | MD | Professional Counselor |
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.
-
- Psychologist
- Taylor, MI
- NPI 1295866135
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1342051200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1784592000000",
"number": "1457616609",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "22550 HALL RD",
"city": "CLINTON TWP",
"state": "MI",
"postal_code": "480361189",
"telephone_number": "586-850-3011"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "29201 TELEGRAPH RD STE 550",
"city": "SOUTHFIELD",
"state": "MI",
"postal_code": "480347664",
"telephone_number": "517-492-0784"
}
],
"practiceLocations": [
{
"address_1": "22550 Hall Rd",
"address_purpose": "LOCATION",
"city": "Clinton Township",
"state": "MI",
"postal_code": "480361189",
"country_code": "US",
"telephone_number": "313-550-3433",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "NOTTAGE",
"first_name": "AMBROSIA",
"name_prefix": "Mrs.",
"credential": "LPC,CRC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-07-12",
"last_updated": "2026-07-21",
"certification_date": "2026-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "MI",
"license": "6401012758",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Southfield, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.