Individual provider Active NPI

Jill Hanna Wasserman, LPC

  • Professional Counselor
  • Auburn Hills, MI
National Provider Identifier
1902156888
Registry record updated Nov 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
6401222712 Issued in MI
Practice address
2251 N Squirrel Rd Ste 315
Auburn Hills, MI 48326-4608
Phone
(517) 492-0784
NPI assigned
Sep 18, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X
Professional Counselor 101YP2500X 6401222712 MI Primary

Addresses

Primary practice location

2251 N Squirrel Rd Ste 315
Auburn Hills, MI 48326-4608

Mailing address

2251 N. Squirrel
Ste 315
Shelby Township, MI 48315-6033
Phone (586) 566-3020

Other practice location 1

45660 Schoenherr Rd
Shelby Township, MI 48315-6033
Phone (586) 566-3020

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
I20241211001826 MI Practitioner - Mental Health Counselor 3870029044 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Downriver Mental Health Clinic PCGroup PAC ID 7911995139, 289 clinicians

Practice addresses (Care Compare)

2251 N Squirrel Rd
Suite 315
Auburn Hills, MI 48326-4608
Phone (517) 492-0784

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Downriver Mental Health Clinic PC CurrentSince Jan 6, 2025 Accepting new patients
Downriver Mental Health Clinic PC Professional CurrentSince Jan 6, 2025 Accepting new patients

Locations

4800 N Scottsdale Rd
Ste 2500
Scottsdale, AZ 85251
Phone (253) 346-0392

2251 N Squirrel Rd
Ste 315
Auburn Hills, MI 48326

2251 N Squirrel Rd
Ste 315320
Auburn Hills, MI 48326

2251 N Squirrel Rd
Ste 320
Auburn Hills, MI 48326
Phone (248) 209-4970

2251 N Squirrel Rd
Ste 316
Auburn Hills, MI 48326

20500 Eureka Rd
Ste 200
Taylor, MI 48180
Phone (734) 285-8282

Organizations & group practices 2

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": "1347926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731456000000",
    "number": "1902156888",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2251 N. SQUIRREL",
            "address_2": "STE 315",
            "city": "SHELBY TOWNSHIP",
            "state": "MI",
            "postal_code": "483156033",
            "telephone_number": "586-566-3020",
            "fax_number": "586-566-3055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2251 N SQUIRREL RD STE 315",
            "city": "AUBURN HILLS",
            "state": "MI",
            "postal_code": "483264608",
            "telephone_number": "517-492-0784"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "45660 Schoenherr Rd",
            "address_purpose": "LOCATION",
            "city": "Shelby Township",
            "state": "MI",
            "postal_code": "483156033",
            "country_code": "US",
            "telephone_number": "586-566-3020",
            "fax_number": "586-566-3055",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WASSERMAN",
        "first_name": "JILL",
        "middle_name": "HANNA",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-09-18",
        "last_updated": "2024-11-13",
        "certification_date": "2024-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MI",
            "license": "6401222712",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Auburn Hills, MI

Sources for this page

Verify at the official NPI Registry.