Active NPI
Mary Jane Madsen, M.A., L.P.C.
- Professional Counselor
- Brighton, MI
National Provider Identifier
1568616662
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 6401009263
- Practice address
- 2300 Genoa Business Park Dr
Suite 106
Brighton, MI 48114-7367 - Phone
- (810) 623-4631
- Fax
- (810) 229-5337
- NPI assigned
- Nov 17, 2008
- 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 | 6401009263 | MI | Primary |
Addresses
Primary practice location
2300 Genoa Business Park Dr
Suite 106
Brighton, MI 48114-7367
Mailing address
779 Westbrooke Dr
South Lyon, MI 48178-1665
Phone (248) 486-8487
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
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6401009263 | MI | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1226880000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1292371200000",
"number": "1568616662",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "779 WESTBROOKE DR",
"city": "SOUTH LYON",
"state": "MI",
"postal_code": "481781665",
"telephone_number": "248-486-8487"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2300 GENOA BUSINESS PARK DR",
"address_2": "SUITE 106",
"city": "BRIGHTON",
"state": "MI",
"postal_code": "481147367",
"telephone_number": "810-623-4631",
"fax_number": "810-229-5337"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MADSEN",
"first_name": "MARY",
"middle_name": "JANE",
"credential": "M.A., L.P.C.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-11-17",
"last_updated": "2010-12-15",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "MI",
"license": "6401009263",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brighton, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.