Individual provider Active NPI

Michael Thomas Marshall, LPC

  • Counselor
  • Jackson, MI
National Provider Identifier
1700829900
Registry record updated Jun 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
6401006358 Issued in MI
Practice address
205 N East Ave
Jackson, MI 49201-1753
Phone
(517) 789-5971
Fax
(517) 789-5718
NPI assigned
Jun 14, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 6401006358 MI
Professional Counselor 101YP2500X 6401006358 MI
Social Worker 104100000X 6802059251 MI
Counselor 101Y00000X 6401006358 MI Primary

Addresses

Primary practice location

205 N East Ave
Jackson, MI 49201-1753

Mailing address

1 Ford PL Ste 3a
Detroit, MI 48202-3450
Phone (313) 874-4806

Other identifiers 1

IdentifierTypeStateIssuer
6401006358OtherMILICENSED COUNSELOR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6802059251MIMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
W. a. Foote Memorial Hospital, Inc. Professional Current Accepting new patients

Locations

1 Ford Pl
Ste 3A
Detroit, MI 48202
Phone (313) 874-2892

205 N East Ave
Jackson, MI 49201
Phone (517) 788-4730

Interoperability endpoints

  • Direct secure messaging: mmarshall454936@direct.hfhs.org

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": "1150243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750377600000",
    "number": "1700829900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 FORD PL STE 3A",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482023450",
            "telephone_number": "313-874-4806",
            "fax_number": "313-876-1305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 N EAST AVE",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492011753",
            "telephone_number": "517-789-5971",
            "fax_number": "517-789-5718"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARSHALL",
        "first_name": "MICHAEL",
        "middle_name": "THOMAS",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-14",
        "last_updated": "2025-06-20",
        "certification_date": "2025-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MI",
            "license": "6401006358",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MI",
            "license": "6401006358",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MI",
            "license": "6802059251",
            "primary": false
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "MI",
            "license": "6401006358",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSED COUNSELOR",
            "identifier": "6401006358",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MI

Sources for this page

Verify at the official NPI Registry.