Individual provider Active NPI

Leslie L Thompson

  • Mental Health Counselor
  • Mount Clemens, MI
National Provider Identifier
1659660926
Registry record updated Apr 7, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
6801071181 Issued in MI
Practice address
175 N Groesbeck Hwy
Mount Clemens, MI 48043-1562
Phone
(586) 627-0024
Fax
(586) 627-0027
NPI assigned
Apr 7, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 6801071181 MI Primary

Addresses

Primary practice location

175 N Groesbeck Hwy
Mount Clemens, MI 48043-1562

Mailing address

175 N Groesbeck Hwy
Mount Clemens, MI 48043-1562
Phone (586) 627-0024

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
I20110412000848 MI Practitioner - Clinical Social Worker 7315121563 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

2950 W Square Lake Rd
Suite 108
Troy, MI 48098-5725
Phone (248) 701-5199

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6801071181MIMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Tranquil Solutions Counseling, PC Clinical CurrentSince Dec 4, 2024 Accepting new patients
Downriver Mental Health Clinic PC Mental Health Past Accepting new patients

Locations

2950 W Square Lake Rd
Ste 108
Troy, MI 48098
Phone (248) 701-5199

Interoperability endpoints

  • Direct secure messaging: lifestancehealth.lesliethompson@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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1302134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1302134400000",
    "number": "1659660926",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "175 N GROESBECK HWY",
            "city": "MOUNT CLEMENS",
            "state": "MI",
            "postal_code": "480431562",
            "telephone_number": "586-627-0024",
            "fax_number": "586-627-0027"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "175 N GROESBECK HWY",
            "city": "MOUNT CLEMENS",
            "state": "MI",
            "postal_code": "480431562",
            "telephone_number": "586-627-0024",
            "fax_number": "586-627-0027"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMPSON",
        "first_name": "LESLIE",
        "middle_name": "L",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-04-07",
        "last_updated": "2011-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MI",
            "license": "6801071181",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Clemens, MI

Sources for this page

Verify at the official NPI Registry.