KATIE ALYSSA PADULA (M.A) – Professional Counselor, NPI 1740530773

KATIE ALYSSA PADULA (M.A) is a healthcare provider. based in Clinton township, Michigan. specializing in CLINICAL PSYCHOLOGIST. They hold the professional credentials M.A. They hold a License No. 6401013271 (MI). The NPI Number for KATIE ALYSSA PADULA (M.A) is 1740530773

Main info

Female
Sole Proprietor
14 Years Of Experience
Accepts Medicare Assignment
Name
KATIE ALYSSA PADULA (M.A)
NPI
1740530773
Phone
(810) 614-8760
Address
43121 BROOKS DR
Enumeration Date
18 September 2012
Last Update Date
11 February 2021

Doctor Profile

Medical School Name
OTHER
Secondary Phone
5867773200
Graduation Year
2012 (14 years ago)
PAC ID
9032657432
Group Practice PAC ID
3274968672
Professional Enrollment ID
I20240816000638
Address ID
MI480822607SA29750AVEX300
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience50
Completeness75
Years active:13State licenses:1Digital endpointsOther names

1,216 CLINICAL PSYCHOLOGIST in MI

Provider Addresses for KATIE ALYSSA PADULA (M.A)

  • 43121 BROOKS DR

    CLINTON TOWNSHIP, MI 480385321

    Phone: (810) 614-8760

    Type: Mailing

  • 20174 WINDEMERE DR

    MACOMB, MI 480443524

    Phone: (810) 614-8760

    Type: Mailing

  • 29750 HARPER AVE

    SAINT CLAIR SHORES, MI 480822607

    Phone: (586) 777-3200

    Fax: (586) 777-7855

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2024-08-16

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20240816000638IClinical PsychologistMITBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 48038)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 3274968672View full group profile
NameSpecialtyState
Clinical PsychologistMI
Clinical Social WorkerMI
Mental Health CounselorMI
Mental Health CounselorMI
Clinical Social WorkerMI
Mental Health CounselorMI

Reviews

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Frequently asked questions

Can I verify KATIE ALYSSA PADULA (M.A) with an NPI only?
You can start verification with NPI 1740530773 for KATIE ALYSSA PADULA (M.A), then check state licensing separately.
Is KATIE ALYSSA PADULA (M.A) still practicing?
KATIE ALYSSA PADULA (M.A) is currently listed as active in the public NPI registry.
What taxonomy line describes KATIE ALYSSA PADULA (M.A)?
For research purposes, treat KATIE ALYSSA PADULA (M.A) as Professional Counselor in this dataset. Clinical services aligned with this taxonomy classification.
What address line appears for KATIE ALYSSA PADULA (M.A)?
KATIE ALYSSA PADULA (M.A)'s geographic hint is Clinton Township, Michigan in our summary view.
What does 'Individual Provider' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.

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