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ASCENSION MEDICAL GROUP PROMED
NPI 1063542165
Counselor in Portage, MI

Active since March 07, 2007CLIA 23D2080812 · Waiver
8001 ANGLING RD, PORTAGE, MI 49024(269) 321-7090 Get Directions Write a Review

NPPES record last updated: December 30, 2022. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Dec 30, 2022, Dec 3, 2021, Feb 22, 2018 (3 updates tracked since 2018).

About Ascension Medical Group Promed NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ASCENSION MEDICAL GROUP PROMED (NPI 1063542165) is a healthcare organization registered as a counselor in Portage, Michigan and active in the NPI registry since March 2007. The organization holds a CLIA Waiver certificate valid through July 14, 2028 and lists Marina Houghton, Cfo, as its authorized official.

NPPES Registry Identity

NPI1063542165
Entity TypeOrganization
Primary Taxonomy101Y00000X
Legal Business NameASCENSION MEDICAL GROUP PROMED
Location Address8001 ANGLING RDPortage, MI 49024-7422
Mailing Address1717 Shaffer St Ste 2Kalamazoo, MI 49048-1623 · (269) 552-2836
Phone(269) 321-7090
Organization SubpartNo
Authorized OfficialMarina HoughtonCfo · (269) 226-4800
Enumeration DateMarch 7, 2007
Last NPPES UpdateDecember 30, 20223 updates tracked since enumeration
NPPES CertifiedDecember 30, 2022
✔ NPI 1063542165 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselorBehavioral Health & Social Service Providers
Taxonomy Code101Y00000X
Definition
A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification.
8001 ANGLING RD, Portage, MI 49024
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Other Identifiers 1

Other750910577MI · Bcbsm Group #

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 23D2080812

Ascension Medical Group Promed · Portage, MI
Active · expires Jul 14, 2028
CLIA Number23D2080812
Laboratory TypeImmediate Medical Care
Certificate Effective DateJuly 15, 2026
Certificate Expiration DateJuly 14, 2028
Laboratory DirectorDavid Brown
Laboratory Phone(269) 324-8405
Laboratory LocationAscension Medical Group Promed7901 Angling Road Attn Jessica Cook, Portage, MI 49024
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 10

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

LINDA GARRISON
Pediatrics
8001 ANGLING RD
PORTAGE, MI 49024
Kalamazoo County (269) 329-0944
THOMAS R AKLAND DO
Pediatrics
8001 ANGLING RD
PORTAGE, MI 49024
Kalamazoo County (269) 329-0944
NICOLETTE P BAUMGARTNER MD
Pediatrics
8001 ANGLING RD
PORTAGE, MI 49024
Kalamazoo County (269) 226-2500
ERIC DARNALL PMH-NP
Nurse Practitioner (Psychiatric/Mental Health)
8001 ANGLING RD
PORTAGE, MI 49024
Kalamazoo County (269) 321-7090
MRS. MYA MARIE MALLAD LLMSW
Social Worker (Clinical)
8001 ANGLING RD
PORTAGE, MI 49024
Kalamazoo County (269) 321-7090
MRS. RYANE VALERIE LEPPARD MSPT
Physical Therapist
8001 ANGLING RD
PORTAGE, MI 49024
Kalamazoo County (269) 321-7200
VISITING NURSES HOME CARE
Nursing Care
8001 ANGLING RD
PORTAGE, MI 49024
Kalamazoo County (269) 323-2325
MS. KAREN MARIE SAUER PT
Physical Therapist
8001 ANGLING RD
PORTAGE, MI 49024
Kalamazoo County (269) 321-7200

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Ascension Medical Group Promed's NPI number?

The NPI number for Ascension Medical Group Promed is 1063542165. It was assigned to this organization in the NPPES registry on March 7, 2007.

Where is Ascension Medical Group Promed located?

Ascension Medical Group Promed is located at 8001 Angling Rd, Portage, MI 49024. The listed phone number is (269) 321-7090.

What is Ascension Medical Group Promed's specialty?

The primary specialty registered for this NPI is Counselor with taxonomy code 101Y00000X.

Does Ascension Medical Group Promed hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 23D2080812) is associated with this NPI, valid through July 14, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Ascension Medical Group Promed was last updated on December 30, 2022. NPI Profile syncs with the weekly NPPES data releases published by CMS.