Individual provider Active NPI

Tawanna D Ross, LPC

  • Professional Counselor
  • Canton, MI
National Provider Identifier
1538552633
Registry record updated Jun 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
Practice address
5958 N Canton Center Rd Ste 900
Canton, MI 48187-2740
Phone
(734) 737-1200
Fax
(734) 737-1205
NPI assigned
Mar 13, 2015
Last updated
Jun 19, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 19, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X 6451017686 MI
Professional Counselor 101YP2500X NU Primary

Addresses

Primary practice location

5958 N Canton Center Rd Ste 900
Canton, MI 48187-2740

Mailing address

51074 Mott Rd TRLR 28
Canton, MI 48188-2139
Phone (734) 725-1143

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250625003355 MI Practitioner - Mental Health Counselor 4789196692 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Downriver Mental Health Clinic PCGroup PAC ID 7911995139, 289 clinicians

Practice addresses (Care Compare)

5958 N Canton Ctr Rd
Suite 900
Canton, MI 48187-2740
Phone (734) 737-1200

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6451017686MIMDCounselor

Practice roles

OrganizationSpecialtyStatusNew patients
Downriver Mental Health Clinic PC Professional CurrentSince May 1, 2025 Accepting new patients
Downriver Mental Health Clinic PC CurrentSince May 1, 2025 Accepting new patients

Locations

4800 N Scottsdale Rd
Ste 2500
Scottsdale, AZ 85251
Phone (253) 346-0392

5958 N Canton Center Rd
Ste 900
Canton, MI 48187
Phone (734) 408-1149

1400 Abbot Rd
Ste 400
East Lansing, MI 48823
Phone (810) 220-2787

Interoperability endpoints

  • Direct secure messaging: lifestancehealth.tawannaross@150339.advancedmd-direct.com

Organizations & group practices 2

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": "1426204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750291200000",
    "number": "1538552633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "51074 MOTT RD TRLR 28",
            "city": "CANTON",
            "state": "MI",
            "postal_code": "481882139",
            "telephone_number": "734-725-1143"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5958 N CANTON CENTER RD STE 900",
            "city": "CANTON",
            "state": "MI",
            "postal_code": "481872740",
            "telephone_number": "734-737-1200",
            "fax_number": "734-737-1205"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSS",
        "first_name": "TAWANNA",
        "middle_name": "D",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-03-13",
        "last_updated": "2025-06-19",
        "certification_date": "2025-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "MI",
            "license": "6451017686",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canton, MI

Sources for this page

Verify at the official NPI Registry.