Michael Marcum, LADC

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

Practice address

2350 Cleveland Ave N
Roseville, MN 55113-2701

Phone

(507) 850-1100

NPI assigned

Jul 22, 2024

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• Community Medical Services Montana Private LLC

  dba Community Medical Services-Minneapolis on Broadway

  • Methadone Clinic
  • Minneapolis, MN
  • NPI 1033804653

  Addiction (Substance Use Disorder)

  NPD (past)
• Community Medical Services Montana-Private, LLC

  dba Community Medical Services

  • Methadone Clinic
  • Roseville, MN
  • NPI 1053069005

  Addiction (Substance Use Disorder)

  NPD (past)

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

{
    "created_epoch": "1721606400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721606400000",
    "number": "1467280651",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8444 N 90TH ST STE 100",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852584437",
            "telephone_number": "602-248-8886"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2350 CLEVELAND AVE N",
            "city": "ROSEVILLE",
            "state": "MN",
            "postal_code": "551132701",
            "telephone_number": "507-850-1100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1020 W Broadway Ave",
            "address_purpose": "LOCATION",
            "city": "Minneapolis",
            "state": "MN",
            "postal_code": "554112504",
            "country_code": "US",
            "telephone_number": "612-895-3850",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARCUM",
        "first_name": "MICHAEL",
        "credential": "LADC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-07-22",
        "last_updated": "2024-07-22",
        "certification_date": "2024-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tatiana Mamaliga, MD
• Courtnie Mann
• Patty-Jo Katherine Mantel, DNP
• Christine Lee Manthey, MA, LPC
• Maple Psychiatry
• Brian Scott Martell, M.D.
• Sharon Mason, M.A. L.P.
• Hassan Mohamed Fouad Masroujeh, DMD
• Cheryl Kay Matascastillo, L.M.F.T.
• Mary Mateffy

• Addiction (Substance Use Disorder) Counselor in Roseville, MN
• Providers in Roseville, MN by specialty
• Addiction (Substance Use Disorder) Counselor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.