Individual provider Active NPI

Sydney Paradise Tremont

  • Professional Counselor
  • Ferndale, MI
National Provider Identifier
1609240373
Registry record updated Apr 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
6401015093 Issued in MI
Practice address
23231 Woodward Ave
Ferndale, MI 48220-1361
Phone
(248) 581-8777
Fax
(888) 975-9374
NPI assigned
Nov 18, 2015
Last updated
Apr 6, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2021

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 6401015093 MI Primary

Addresses

Primary practice location

23231 Woodward Ave
Ferndale, MI 48220-1361

Mailing address

23231 Woodward Ave
Ferndale, MI 48220-1361
Phone (248) 581-8777

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
I20240826002035 MI Practitioner - Mental Health Counselor 5890234553 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6401015093MIMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Fairsky Foundation Professional CurrentSince Apr 11, 2021 Accepting new patients
Paradise Art Therapy Center LLC Counselor CurrentSince Jun 8, 2024 Accepting new patients

Locations

23231 Woodward Ave
Ferndale, MI 48220
Phone (248) 565-6556

2020 Raybrook St SE
Ste 203
Grand Rapids, MI 49546
Phone (616) 285-9600

464 N Main St
Plymouth, MI 48170
Phone (734) 255-3439

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": "1447804800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617667200000",
    "number": "1609240373",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23231 WOODWARD AVE",
            "city": "FERNDALE",
            "state": "MI",
            "postal_code": "482201361",
            "telephone_number": "248-581-8777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23231 WOODWARD AVE",
            "city": "FERNDALE",
            "state": "MI",
            "postal_code": "482201361",
            "telephone_number": "248-581-8777",
            "fax_number": "888-975-9374"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TREMONT",
        "first_name": "SYDNEY",
        "middle_name": "PARADISE",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-11-18",
        "last_updated": "2021-04-06",
        "certification_date": "2021-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MI",
            "license": "6401015093",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ferndale, MI

Sources for this page

Verify at the official NPI Registry.