Individual provider Active NPI

Julianne Marie Fittonneville, LPC

  • Mental Health Counselor
  • Waterford, MI
National Provider Identifier
1932699741
Registry record updated Mar 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
6401017347 Issued in MI
Practice address
4000 W Walton Blvd Ste a&B
Waterford, MI 48329
Phone
(248) 426-6266
NPI assigned
May 16, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X 6401017347 MI
Mental Health Counselor 101YM0800X 6401017347 MI Primary

Addresses

Primary practice location

4000 W Walton Blvd Ste a&B
Waterford, MI 48329

Mailing address

4000 W Walton Blvd Ste B
Waterford, MI 48329-4191
Phone (248) 461-6266

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
I20260302001538 MI Practitioner - Mental Health Counselor 7012499890 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2016
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

4000 W Walton Blvd
Suite B
Waterford, MI 48329-4191

885 Penniman Ave
Unit 5425
Plymouth, MI 48170-7729

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6401017347MIMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Lifelens Psychological and Counseling Services Counselor CurrentSince Jan 10, 2026 Accepting new patients

Locations

4000 W Walton Blvd
Ste B
Waterford, MI 48329
Phone (248) 461-6266

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": "1526428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774310400000",
    "number": "1932699741",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4000 W WALTON BLVD STE B",
            "city": "WATERFORD",
            "state": "MI",
            "postal_code": "483294191",
            "telephone_number": "248-461-6266"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4000 W WALTON BLVD STE A&B",
            "city": "WATERFORD",
            "state": "MI",
            "postal_code": "48329",
            "telephone_number": "248-426-6266"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FITTONNEVILLE",
        "first_name": "JULIANNE",
        "middle_name": "MARIE",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-16",
        "last_updated": "2026-03-24",
        "certification_date": "2026-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "MI",
            "license": "6401017347",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MI",
            "license": "6401017347",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waterford, MI

Sources for this page

Verify at the official NPI Registry.