Mark Carpenter, LPC
Individual provider Active NPI Professional Counselor · Fenton, MI
NPI 1720450596 · NPPES record last updated Jun 24, 2022
Key facts
- NPI
- 1720450596
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Professional Counselor 101YP2500X
- License
- 6401011415 (MI)
- Practice address
- 14165 N Fenton Rd Ste 102A2
Fenton, MI 48430-1186 - Phone
- (810) 282-4093
- NPI assigned
- Oct 20, 2015
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 3
Medicare Care Compare profile
- Specialty
- Mental Health Counselor
- Education
- Other, 2009
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Total Life FL PA
Practice addresses (Care Compare)
3200 Greenfield Rd
Suite 300
Dearborn, MI 48120-1805
Phone (800) 567-5433
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240807000399 | MI | Practitioner - Mental Health Counselor | 2668819988 | Reassigns benefits to 3 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Darkness Recovery, LLC | Professional | Current |
Accepting new patients |
Locations
14165 N Fenton Rd
Ste 102A2
Fenton, MI 48430
Phone (810) 282-4093
6650 Highland Rd
Ste 219
Waterford, MI 48327
Phone (810) 282-4093
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 6401011415 | MI | |
| Professional Counselor | 101YP2500X | 6401011415 | MI | Yes |
Addresses
Primary practice location
14165 N Fenton Rd Ste 102A2
Fenton, MI 48430-1186
Mailing address
14165 N Fenton Rd Ste 102A2
Fenton, MI 48430-1186
Phone (810) 282-4093
Other providers in Fenton, MI
- James Michael Callard
- Kimberly Ann Cardeccia
- Samantha Cardenas
- James Carlo
- Janice Carol
- Deborah Carter
- Glenn B. Carter
- Andrea W Casey
- Ashley Hasan Casey
- Crystal Castle
All providers in Fenton, MI · Professional Counselor in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 24, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.