Individual provider Active NPI

Trista Palmer, LPC

  • Professional Counselor
  • Chelsea, MI
National Provider Identifier
1851802003
Registry record updated Jan 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
6401015996 Issued in MI
Practice address
636 N Main St
Chelsea, MI 48118-1628
Phone
(734) 623-9111
NPI assigned
Oct 16, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 6401015996 MI Primary

Addresses

Primary practice location

636 N Main St
Chelsea, MI 48118-1628

Mailing address

636 N Main St
Chelsea, MI 48118-1628
Phone (734) 623-9111

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
I20260625000563 MI Practitioner - Mental Health Counselor 5294208880 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 1998
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

12453 Roepke Rd
Gregory, MI 48137-9785

7444 Dexter Ann Arbor Rd
Suite J
Dexter, MI 48130-1468

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6401015996MIMDProfessional Counselor

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": "1508112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609977600000",
    "number": "1851802003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "636 N MAIN ST",
            "city": "CHELSEA",
            "state": "MI",
            "postal_code": "481181628",
            "telephone_number": "734-623-9111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "636 N MAIN ST",
            "city": "CHELSEA",
            "state": "MI",
            "postal_code": "481181628",
            "telephone_number": "734-623-9111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PALMER",
        "first_name": "TRISTA",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-16",
        "last_updated": "2021-01-07",
        "certification_date": "2021-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MI",
            "license": "6401015996",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chelsea, MI

Sources for this page

Verify at the official NPI Registry.