NPIMap

Organization Active NPI

Macomb Therapy Group, PLLC

  • Professional Counselor
  • Clinton Township, MI
National Provider Identifier
1801245972
Registry record updated Jun 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
6401010333 Issued in MI
Legal business name
MACOMB THERAPY GROUP, PLLC
Practice address
42815 Garfield Rd Ste 201
Clinton Township, MI 48038-1143
Phone
(586) 333-5328
Fax
(586) 948-9304
NPI assigned
Jun 8, 2016
Last updated
Jun 21, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2021

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

Authorized official

Name
Angela Marie Kosmas, MA, LPC, NCCNPI 1962720805
Title
Licensed Professional Counselor
Phone
(586) 333-5328

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 6401010333 MI Primary
Clinical Social Worker 1041C0700X NU

Addresses

Primary practice location

42815 Garfield Rd Ste 201
Clinton Township, MI 48038-1143

Mailing address

42815 Garfield Rd Ste 201
Clinton Township, MI 48038-1143
Phone (586) 333-5328

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170922000785 MI Part B Supplier - Clinic/Group Practice 4981978418 Receives reassigned benefits from 28 practitioners
Practice locations: Clinton Township, MI

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 32

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 32

NPI Registry JSON

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

{
    "created_epoch": "1465344000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1624233600000",
    "number": "1801245972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "42815 GARFIELD RD STE 201",
            "city": "CLINTON TOWNSHIP",
            "state": "MI",
            "postal_code": "480381143",
            "telephone_number": "586-333-5328",
            "fax_number": "586-948-9304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "42815 GARFIELD RD STE 201",
            "city": "CLINTON TOWNSHIP",
            "state": "MI",
            "postal_code": "480381143",
            "telephone_number": "586-333-5328",
            "fax_number": "586-948-9304"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MACOMB THERAPY GROUP, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-08",
        "last_updated": "2021-06-21",
        "certification_date": "2021-06-21",
        "status": "A",
        "authorized_official_last_name": "KOSMAS",
        "authorized_official_first_name": "ANGELA",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "LICENSED PROFESSIONAL COUNSELOR",
        "authorized_official_telephone_number": "586-333-5328",
        "authorized_official_credential": "MA, LPC, NCC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MI",
            "license": "6401010333",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clinton Township, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.