Mary A Mummaw, LPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

6401010130 Issued in MI

Practice address

10139 E Grandview Rd
Traverse City, MI 49684-5429

Phone

(989) 293-4927

NPI assigned

May 7, 2009

Last updated

Oct 2, 2025By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Specialty

Mental Health Counselor

Education

Other, 2006

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Stillwater Teletherapy PLLC

  • Mental Health Counselor
  • Traverse City, MI
  • NPI 1023979358
  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1241654400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759363200000",
    "number": "1730313552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10139 E GRANDVIEW RD",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496845429",
            "telephone_number": "989-293-4927"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10139 E GRANDVIEW RD",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496845429",
            "telephone_number": "989-293-4927"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "605 Beckon Rd",
            "address_purpose": "LOCATION",
            "city": "Pellston",
            "state": "MI",
            "postal_code": "497699315",
            "country_code": "US",
            "telephone_number": "989-293-4927",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MUMMAW",
        "first_name": "MARY",
        "middle_name": "A",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-05-07",
        "last_updated": "2025-10-02",
        "certification_date": "2025-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MI",
            "license": "6401010130",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1477745370",
            "state": "MT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Daniel Thomas Muladore, MSPA
• Zita Antoinette Muladore, FNP-C
• Hannah Rose Mulder, DPT
• Kathi Lynne Mulder, CPM LM
• Sarah Christine Mulder, M.D.
• Amy I. Mummert, O.D.
• Mark S Munro, MD
• Munson Dialysis Center
• Munson Healthcare Cadillac
• Munson Healthcare Cadillac

• Mental Health Counselor in Traverse City, MI
• Providers in Traverse City, MI by specialty
• Mental Health Counselor in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2025; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.