Individual provider Active NPI

Mary Jo Ciani

  • Mental Health Counselor
  • Mount Clemens, MI
National Provider Identifier
1932457595
Registry record updated Jan 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
L2195774 Issued in MI
Practice address
22 Church St
Mount Clemens, MI 48043-2351
Phone
(586) 466-5960
NPI assigned
Aug 29, 2012
Last updated
Jan 5, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 5, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X L2195774 MI Primary

Addresses

Primary practice location

22 Church St
Mount Clemens, MI 48043-2351

Mailing address

22 Church St
Mount Clemens, MI 48043-2351
Phone (586) 466-5960

Other names 1

  • Mary Jo Ciani-Gaddie Other name

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
I20231219002664 MI Practitioner - Mental Health Counselor 1951751825 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Central Michigan College of Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
H3 - Hope, Healing and Health IncGroup PAC ID 4486915055, 11 clinicians

Practice addresses (Care Compare)

23100 Jefferson Ave
Saint Clair Shores, MI 48080-2756
Phone (586) 335-2006

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
L2195774MIMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Lumina Counseling & Wellness, PLLC Current Accepting new patients
Fischer & Cardamone, LLC Past Accepting new patients

Locations

23780 Harper Ave
Ste B
St Clr Shores, MI 48080
Phone (313) 402-5861

Organizations & group practices 3

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": "1346198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704412800000",
    "number": "1932457595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 CHURCH ST",
            "city": "MOUNT CLEMENS",
            "state": "MI",
            "postal_code": "480432351",
            "telephone_number": "586-466-5960"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 CHURCH ST",
            "city": "MOUNT CLEMENS",
            "state": "MI",
            "postal_code": "480432351",
            "telephone_number": "586-466-5960"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CIANI",
        "first_name": "MARY JO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-08-29",
        "last_updated": "2024-01-05",
        "certification_date": "2024-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MI",
            "license": "L2195774",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY JO",
            "last_name": "CIANI-GADDIE",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Mount Clemens, MI

Sources for this page

Verify at the official NPI Registry.