Individual provider Active NPI

Judy Carethers, MA LPC IGDC

  • Mental Health Counselor
  • Southfield, MI
National Provider Identifier
1861236481
Registry record updated Jun 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
6401223476 Issued in MI
Practice address
25245 Grand Concourse St
Southfield, MI 48075-1744
Phone
(248) 854-4692
NPI assigned
Jun 19, 2024
Last updated
Jun 19, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 19, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 6401223476 MI Primary
Professional Counselor 101YP2500X 6401223476 MI

Addresses

Primary practice location

25245 Grand Concourse St
Southfield, MI 48075-1744

Mailing address

PO Box 760179
Lathrup Village, MI 48076-0179
Phone (248) 854-4692

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
I20240830003356 MI Practitioner - Mental Health Counselor 3476092602 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1718755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718755200000",
    "number": "1861236481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 760179",
            "city": "LATHRUP VILLAGE",
            "state": "MI",
            "postal_code": "480760179",
            "telephone_number": "248-854-4692"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25245 GRAND CONCOURSE ST",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480751744",
            "telephone_number": "248-854-4692"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARETHERS",
        "first_name": "JUDY",
        "credential": "MA LPC IGDC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-06-19",
        "last_updated": "2024-06-19",
        "certification_date": "2024-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MI",
            "license": "6401223476",
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MI",
            "license": "6401223476",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southfield, MI

Sources for this page

Verify at the official NPI Registry.