Active NPI
Patricia Ann Gundrum, MSW,LMSW
- Professional Counselor
- Okemos, MI
National Provider Identifier
1497999650
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 6801073024
- Practice address
- 3493 Woods Edge
Suite 103
Okemos, MI 48864-5911 - Phone
- (517) 886-3707
- Fax
- (517) 349-1973
- NPI assigned
- Apr 30, 2009
- Last updated
- Feb 9, 2011
- 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 | 6801073024 | MI | Primary |
Addresses
Primary practice location
3493 Woods Edge
Suite 103
Okemos, MI 48864-5911
Mailing address
PO Box 43
Mason, MI 48854-0043
Phone (517) 623-6260
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 800313060 | Other | MI | BLUE CROSS BLUE SHIELD OF MICHIGAN |
Other names 1
- Mrs. Patricia Ann Gundrum
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)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mareck Family and Geriatric Services, P.C. | Past | Accepting new patients |
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.
-
dba Mareck and Associates
- Adult Mental Health Clinic/Center
- Okemos, MI
- NPI 1073615092
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1241049600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1297209600000",
"number": "1497999650",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 43",
"city": "MASON",
"state": "MI",
"postal_code": "488540043",
"telephone_number": "517-623-6260",
"fax_number": "517-623-6460"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3493 WOODS EDGE",
"address_2": "SUITE 103",
"city": "OKEMOS",
"state": "MI",
"postal_code": "488645911",
"telephone_number": "517-886-3707",
"fax_number": "517-349-1973"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GUNDRUM",
"first_name": "PATRICIA",
"middle_name": "ANN",
"name_prefix": "Mrs.",
"credential": "MSW,LMSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-04-30",
"last_updated": "2011-02-09",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "MI",
"license": "6801073024",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD OF MICHIGAN",
"identifier": "800313060",
"state": "MI"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "PATRICIA",
"last_name": "GUNDRUM",
"middle_name": "ANN",
"prefix": "MRS.",
"credential": "MSW,LMSW",
"code": "5",
"type": "Other Name"
}
]
}Other providers in Okemos, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.