Individual provider Active NPI

Marilyn Shantey Buford

  • Counselor
  • Grand Rapids, MI
National Provider Identifier
1649049024
Registry record updated Dec 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
Practice address
755 36TH St SE
Grand Rapids, MI 49548-2319
Phone
(616) 301-8000
NPI assigned
Dec 27, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 27, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X MI Primary

Addresses

Primary practice location

755 36TH St SE
Grand Rapids, MI 49548-2319

Mailing address

755 36TH St SE
Grand Rapids, MI 49548-2319

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
I20260425000223 MI Practitioner - Mental Health Counselor 8325515570 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Downriver Mental Health Clinic PCGroup PAC ID 7911995139, 289 clinicians

Practice addresses (Care Compare)

3950 Sparks Dr SE
Suite 103
Grand Rapids, MI 49546-6159
Phone (517) 882-3732

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1703635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703635200000",
    "number": "1649049024",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "755 36TH ST SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495482319"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "755 36TH ST SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495482319",
            "telephone_number": "616-301-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUFORD",
        "first_name": "MARILYN",
        "middle_name": "SHANTEY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-12-27",
        "last_updated": "2023-12-27",
        "certification_date": "2023-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "MI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

Verify at the official NPI Registry.