Individual provider Active NPI

Anthony Michael Benedict, LLPC

  • Professional Counselor
  • Ypsilanti, MI
National Provider Identifier
1497306633
Registry record updated Mar 31, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
6401017760 Issued in MI
Practice address
2520 Packard Rd Ste 4
Ypsilanti, MI 48197-2245
Phone
(734) 480-8099
NPI assigned
Sep 27, 2019
Last updated
Mar 31, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 6401017760 MI Primary

Addresses

Primary practice location

2520 Packard Rd Ste 4
Ypsilanti, MI 48197-2245

Mailing address

147 Oakland Dr
East Lansing, MI 48823-4714
Phone (517) 898-7574

Other practice location 1

724 E Superior St
Alma, MI 48801-1900
Phone (989) 796-4555

Other practice location 2

1505 Waterford Pkwy
Saint Johns, MI 48879-9630
Phone (989) 292-3572

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
6401017760MIMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Prosperity Counseling and Supervision, LLC CurrentSince Nov 6, 2022 Accepting new patients

Locations

2520 Packard Rd
Ste 4
Ypsilanti, MI 48197
Phone (734) 219-5015

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1569542400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648684800000",
    "number": "1497306633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "147 OAKLAND DR",
            "city": "EAST LANSING",
            "state": "MI",
            "postal_code": "488234714",
            "telephone_number": "517-898-7574"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2520 PACKARD RD STE 4",
            "city": "YPSILANTI",
            "state": "MI",
            "postal_code": "481972245",
            "telephone_number": "734-480-8099"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "724 E Superior St",
            "address_purpose": "LOCATION",
            "city": "Alma",
            "state": "MI",
            "postal_code": "488011900",
            "country_code": "US",
            "telephone_number": "989-796-4555",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1505 Waterford Pkwy",
            "address_purpose": "LOCATION",
            "city": "Saint Johns",
            "state": "MI",
            "postal_code": "488799630",
            "country_code": "US",
            "telephone_number": "989-292-3572",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BENEDICT",
        "first_name": "ANTHONY",
        "middle_name": "MICHAEL",
        "name_prefix": "Mr.",
        "credential": "LLPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-09-27",
        "last_updated": "2022-03-31",
        "certification_date": "2022-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MI",
            "license": "6401017760",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ypsilanti, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2022; 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.