Individual provider Active NPI

Melissa Kimberly Porembiak, MA, LPC, NCC

  • Mental Health Counselor
  • Bloomfield Hills, MI
National Provider Identifier
1720635857
Registry record updated Sep 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
6401223894 Issued in MI
Practice address
10 W Square Lake Rd Ste 302
Bloomfield Hills, MI 48302-0468
Phone
(248) 277-5353
Fax
(248) 250-5482
NPI assigned
Aug 22, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X
Mental Health Counselor 101YM0800X 6401223894 MI Primary

Addresses

Primary practice location

10 W Square Lake Rd Ste 302
Bloomfield Hills, MI 48302-0468

Mailing address

10 W Square Lake Rd Ste 302
Bloomfield Hills, MI 48302-0468
Phone (248) 277-5353

Other practice location 1

43329 Schoenherr Rd
Sterling Heights, MI 48313-1959
Phone (248) 277-5353

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: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Thaar Care Foundation IncGroup PAC ID 2668815879, 6 clinicians

Practice addresses (Care Compare)

10 W Square Lake Rd
Bloomfield Hills, MI 48302-0468
Phone (248) 277-5353

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
6401223894MIMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Thaar Care Foundation, Inc Mental Health CurrentSince Jan 4, 2024 Accepting new patients
Ameriflex Home Health Care, Inc. Past Accepting new patients

Locations

10 W Square Lake Rd
Ste 302
Bloomfield Hills, MI 48302
Phone (248) 277-5353

43329 Schoenherr Rd
Sterling Heights, MI 48313
Phone (248) 277-5353

2820 W Maple Rd
Ste 130
Troy, MI 48084
Phone (248) 277-5353

2820 W Maple Rd
Ste 229
Troy, MI 48084

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": "1566432000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727568000000",
    "number": "1720635857",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 W SQUARE LAKE RD STE 302",
            "city": "BLOOMFIELD HILLS",
            "state": "MI",
            "postal_code": "483020468",
            "telephone_number": "248-277-5353",
            "fax_number": "248-250-5482"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 W SQUARE LAKE RD STE 302",
            "city": "BLOOMFIELD HILLS",
            "state": "MI",
            "postal_code": "483020468",
            "telephone_number": "248-277-5353",
            "fax_number": "248-250-5482"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "43329 Schoenherr Rd",
            "address_purpose": "LOCATION",
            "city": "Sterling Heights",
            "state": "MI",
            "postal_code": "483131959",
            "country_code": "US",
            "telephone_number": "248-277-5353",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "POREMBIAK",
        "first_name": "MELISSA",
        "middle_name": "KIMBERLY",
        "credential": "MA, LPC, NCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-22",
        "last_updated": "2024-09-29",
        "certification_date": "2024-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MI",
            "license": "6401223894",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomfield Hills, MI

Sources for this page

Verify at the official NPI Registry.