Individual provider Active NPI

Nicholas Russeau, MA

  • Professional Counselor
  • Monroe, MI
National Provider Identifier
1992096267
Registry record updated Aug 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
6401012141 Issued in MI
Practice address
214 E Elm Ave Ste 112
Monroe, MI 48162-2678
Phone
(734) 242-4673
Fax
(734) 242-4676
NPI assigned
Apr 21, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 7, 2023

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 6401012141 MI Primary

Addresses

Primary practice location

214 E Elm Ave Ste 112
Monroe, MI 48162-2678

Mailing address

214 E Elm Ave Ste 112
Monroe, MI 48162-2678
Phone (734) 242-4673

Other identifiers 1

IdentifierTypeStateIssuer
2604097MedicaidOH

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
I20251222001183 MI Practitioner - Mental Health Counselor 0547622276 Practice locations: Monroe, MI

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

214 E Elm Ave
Suite 112
Monroe, MI 48162-2678
Phone (734) 242-4673

23 W 1St St
Monroe, MI 48161-2332

4297 Heiss Rd
Monroe, MI 48162-9459

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
6401012141MIMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
You Matter Therapeutic Services CurrentSince Mar 12, 2024 Accepting new patients
Hatcher Yaeger & Associates PastSince Aug 13, 2023 Accepting new patients
Alpha Family Counseling PC Past Accepting new patients

Locations

214 E Elm Ave
Ste 112
Monroe, MI 48162
Phone (734) 242-4673

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1303344000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691366400000",
    "number": "1992096267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "214 E ELM AVE STE 112",
            "city": "MONROE",
            "state": "MI",
            "postal_code": "481622678",
            "telephone_number": "734-242-4673",
            "fax_number": "734-242-4676"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "214 E ELM AVE STE 112",
            "city": "MONROE",
            "state": "MI",
            "postal_code": "481622678",
            "telephone_number": "734-242-4673",
            "fax_number": "734-242-4676"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSEAU",
        "first_name": "NICHOLAS",
        "credential": "MA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-04-21",
        "last_updated": "2023-08-07",
        "certification_date": "2023-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MI",
            "license": "6401012141",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2604097",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Monroe, MI

Sources for this page

Verify at the official NPI Registry.