Active NPI
Marianne M Vandenboom, LMSW
- Mental Health Counselor
- Caro, MI
National Provider Identifier
1841363439
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 6801073813
- Practice address
- 1332 Prospect Avenue
Tuscola Behavioral Health
Caro, MI 48732 - Phone
- (989) 673-6191
- Fax
- (989) 672-3170
- NPI assigned
- Nov 15, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 6801073813 | MI | Primary |
Addresses
Primary practice location
1332 Prospect Avenue
Tuscola Behavioral Health
Caro, MI 48732
Mailing address
323 N. State Street
Tuscola Behavioral Health
Caro, MI 48723
Phone (989) 673-6191
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163548800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1437523200000",
"number": "1841363439",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "323 N. STATE STREET",
"address_2": "TUSCOLA BEHAVIORAL HEALTH",
"city": "CARO",
"state": "MI",
"postal_code": "48723",
"telephone_number": "989-673-6191",
"fax_number": "989-672-2199"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1332 PROSPECT AVENUE",
"address_2": "TUSCOLA BEHAVIORAL HEALTH",
"city": "CARO",
"state": "MI",
"postal_code": "48732",
"telephone_number": "989-673-6191",
"fax_number": "989-672-3170"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VANDENBOOM",
"first_name": "MARIANNE",
"middle_name": "M",
"name_prefix": "Mrs.",
"credential": "LMSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-11-15",
"last_updated": "2015-07-22",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "MI",
"license": "6801073813",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Caro, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.