Active NPI
Michael Phillips, LPC
- Counselor
- Cullman, AL
National Provider Identifier
1720014780
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- 1234
- Practice address
- 101 2ND Ave SE
Cullman, AL 35055-3511 - Phone
- (256) 739-4910
- Fax
- (256) 739-9455
- NPI assigned
- Jun 23, 2006
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Counselor | 101Y00000X | 1234 | AL | Primary |
Addresses
Primary practice location
101 2ND Ave SE
Cullman, AL 35055-3511
Mailing address
503 Clark St NE
Cullman, AL 35055-1921
Phone (256) 739-0801
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 51514993 | Other | AL | BCBS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20151103001546 | AL | Order and Referring Only - Psychiatry | 6103136189 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151020800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1427068800000",
"number": "1720014780",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "503 CLARK ST NE",
"city": "CULLMAN",
"state": "AL",
"postal_code": "350551921",
"telephone_number": "256-739-0801",
"fax_number": "256-739-0027"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "101 2ND AVE SE",
"city": "CULLMAN",
"state": "AL",
"postal_code": "350553511",
"telephone_number": "256-739-4910",
"fax_number": "256-739-9455"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PHILLIPS",
"first_name": "MICHAEL",
"credential": "LPC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-23",
"last_updated": "2015-03-23",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "AL",
"license": "1234",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "51514993",
"state": "AL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Cullman, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.