Lyneah R Blake-Duncan, TLLP

Primary specialty

PsychologistTaxonomy code 103T00000X

Practice address

229 N Sheldon Rd
Plymouth, MI 48170

Phone

(313) 278-4601

NPI assigned

Sep 1, 2011

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Neighborhood Service Organization

  • Community/Behavioral Health Agency
  • Detroit, MI
  • NPI 1891825808
  NPD (past)

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

{
    "created_epoch": "1314835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539820800000",
    "number": "1003197245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "229 N SHELDON RD",
            "city": "PLYMOUTH",
            "state": "MI",
            "postal_code": "481701524"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "229 N SHELDON RD",
            "city": "PLYMOUTH",
            "state": "MI",
            "postal_code": "48170",
            "telephone_number": "313-278-4601"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "220 Bagley St",
            "address_2": "Suite 1200",
            "address_purpose": "LOCATION",
            "city": "Detroit",
            "state": "MI",
            "postal_code": "482261400",
            "country_code": "US",
            "telephone_number": "313-961-4890",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "220 Bagley St",
            "address_2": "Suite 1200",
            "address_purpose": "LOCATION",
            "city": "Detroit",
            "state": "MI",
            "postal_code": "48226",
            "country_code": "US",
            "telephone_number": "313-961-4890",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "229 N Sheldon Rd",
            "address_purpose": "LOCATION",
            "city": "Plymouth",
            "state": "MI",
            "postal_code": "48170",
            "country_code": "US",
            "telephone_number": "313-278-4601",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLAKE-DUNCAN",
        "first_name": "LYNEAH",
        "middle_name": "R",
        "name_prefix": "Ms.",
        "credential": "TLLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-09-01",
        "last_updated": "2018-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "MI",
            "license": "6301015236",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Skyler Blackman
• Tonisha Blackman
• Jacob Blackmon, CCP
• Tyler Lee Blackstock, LLPC. CADC
• Rhianna Blaies
• Trina L Blakeley, LLMSW
• Nathan Blakely
• Jenna Bleser
• Briana Blessing
• Kathy Bley

• Psychologist in Plymouth, MI
• Providers in Plymouth, MI by specialty
• Psychologist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.