Individual provider Active NPI

Tiffany Malory, LPC

  • Professional Counselor
  • Kalamazoo, MI
National Provider Identifier
1568004372
Registry record updated Nov 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
6401223219 Issued in MI
Practice address
2030 Portage St.
Kalamazoo, MI 49001
Phone
(269) 553-7132
NPI assigned
Oct 14, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2023

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 6401223219 MI Primary

Addresses

Primary practice location

2030 Portage St.
Kalamazoo, MI 49001

Mailing address

2030 Portage St
Kalamazoo, MI 49001
Phone (269) 553-7132

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
I20240418004049 MI Practitioner - Mental Health Counselor 4486093747 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Ismail B Sendi MD PCGroup PAC ID 4688674534, 72 clinicians

Practice addresses (Care Compare)

8225 Moorsbridge Rd
Portage, MI 49024-7845
Phone (800) 395-3223

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6401223219MIMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Thrive Counseling LLC CurrentSince Apr 1, 2024 Accepting new patients
Ismail B. Sendi, MD, PC CurrentSince Nov 11, 2024 Accepting new patients
Ismail B. Sendi, MD, PC CurrentSince Nov 11, 2024 Accepting new patients

Locations

6549 Town Center Dr
Ste A
Clarkston, MI 48346
Phone (248) 620-6400

8225 Moorsbridge Rd
Portage, MI 49024

524 E Milham Ave
Ste B
Portage, MI 49002
Phone (269) 264-4920

7333 Triangle Dr
Sterling Hts, MI 48314
Phone (248) 686-3347

1000 Jefferson St
Ste 2C
Lynchburg, VA 24504
Phone (434) 528-3263

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1571011200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699574400000",
    "number": "1568004372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2030 PORTAGE ST",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "49001",
            "telephone_number": "269-553-7132"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2030 PORTAGE ST.",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "49001",
            "telephone_number": "269-553-7132"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALORY",
        "first_name": "TIFFANY",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-14",
        "last_updated": "2023-11-10",
        "certification_date": "2023-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MI",
            "license": "6401223219",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kalamazoo, MI

Sources for this page

Verify at the official NPI Registry.