Individual provider Active NPI

Danielle Ardis Pagan, M.A.

  • Professional Counselor
  • Portage, MI
National Provider Identifier
1992171029
Registry record updated Feb 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
6401015553 Issued in MI
Practice address
1125 E Milham Ave Ste B
Portage, MI 49002-3096
Phone
(269) 312-1446
Fax
(269) 225-6949
NPI assigned
Aug 12, 2015
Last updated
Feb 10, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 10, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 6401015553 MI Primary
Counselor 101Y00000X 6401015553 MI

Addresses

Primary practice location

1125 E Milham Ave Ste B
Portage, MI 49002-3096

Mailing address

PO Box 2174
Kalamazoo, MI 49003-2174
Phone (269) 312-1446

Other practice location 1

11656 Boardman Dr
Onsted, MI 49265-9762
Phone (517) 215-4079

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
I20240228002860 MI Practitioner - Mental Health Counselor 3577908664 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
6401015553MIMDCounselor

Practice roles

OrganizationSpecialtyStatusNew patients
Serene Solutions Professional CurrentSince Feb 10, 2024 Accepting new patients
Danielle Pagan LLC Professional CurrentSince Jan 21, 2024 Accepting new patients

Locations

4341 S Westnedge Ave
Ste 1106
Kalamazoo, MI 49008
Phone (269) 312-1446

1125 E Milham Ave
Ste B
Portage, MI 49002
Phone (269) 312-1446

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, 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": "1439337600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707523200000",
    "number": "1992171029",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2174",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490032174",
            "telephone_number": "269-312-1446",
            "fax_number": "269-225-6949"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1125 E MILHAM AVE STE B",
            "city": "PORTAGE",
            "state": "MI",
            "postal_code": "490023096",
            "telephone_number": "269-312-1446",
            "fax_number": "269-225-6949"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11656 Boardman Dr",
            "address_purpose": "LOCATION",
            "city": "Onsted",
            "state": "MI",
            "postal_code": "492659762",
            "country_code": "US",
            "telephone_number": "517-215-4079",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PAGAN",
        "first_name": "DANIELLE",
        "middle_name": "ARDIS",
        "name_prefix": "Miss",
        "credential": "M.A.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-08-12",
        "last_updated": "2024-02-10",
        "certification_date": "2024-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MI",
            "license": "6401015553",
            "primary": true
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "MI",
            "license": "6401015553",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portage, MI

Sources for this page

Verify at the official NPI Registry.