Individual provider Active NPI

Mary L Digangi, ED.D

  • Counseling Psychologist
  • Niles, MI
National Provider Identifier
1730204728
Registry record updated Aug 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Counseling PsychologistTaxonomy code 103TC1900X
License
6401007591 Issued in MI
Practice address
3130 S 11TH St
Niles, MI 49120-4736
Phone
(574) 277-4985
NPI assigned
Mar 20, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 16, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counseling Psychologist 103TC1900X 6401007591 MI Primary

Addresses

Primary practice location

3130 S 11TH St
Niles, MI 49120-4736

Mailing address

51856 Nebraska LN
Granger, IN 46530-9563
Phone (574) 277-4985

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
I20240910002141 MI Practitioner - Clinical Psychologist 6103366786 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1989
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

3130 S 11TH St
Niles, MI 49120-4736
Phone (574) 277-4985

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6401007591MIMDCounseling Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Michiana Counseling Services Inc CurrentSince Jul 2, 2024 Accepting new patients

Locations

3130 S 11th St
Niles, MI 49120
Phone (269) 635-2396

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": "1174348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723766400000",
    "number": "1730204728",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "51856 NEBRASKA LN",
            "city": "GRANGER",
            "state": "IN",
            "postal_code": "465309563",
            "telephone_number": "574-277-4985"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3130 S 11TH ST",
            "city": "NILES",
            "state": "MI",
            "postal_code": "491204736",
            "telephone_number": "574-277-4985"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIGANGI",
        "first_name": "MARY",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "ED.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-20",
        "last_updated": "2024-08-16",
        "certification_date": "2024-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "MI",
            "license": "6401007591",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Niles, MI

Sources for this page

Verify at the official NPI Registry.