Individual provider Active NPI

Nishani Jayawardena, LPC, NCC

  • Professional Counselor
  • Rochester Hills, MI
National Provider Identifier
1013567700
Registry record updated Jun 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
6401222279 Issued in MI
Practice address
145 Rochdale Dr S Ste F
Rochester Hills, MI 48309-2275
Phone
(248) 608-4514
NPI assigned
Sep 16, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
Professional Counselor 101YP2500X 6401222279 MI Primary

Addresses

Primary practice location

145 Rochdale Dr S Ste F
Rochester Hills, MI 48309-2275

Mailing address

226 Hendrie St
Detroit, MI 48202-3734
Phone (989) 941-6821

Other practice location 1

2925 Russell St
Detroit, MI 48207-4825
Phone (133) 396-5300

Other practice location 2

226 Hendrie St
Detroit, MI 48202-3734
Phone (201) 968-6934

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
6401222279MIMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Attunigrate LLC Professional CurrentSince Jul 3, 2022 Accepting new patients
Tree of Life Counseling Services LLC Professional PastSince Aug 1, 2022 Accepting new patients

Locations

47610 Grand River Ave
Novi, MI 48374
Phone (248) 422-2440

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1568592000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654905600000",
    "number": "1013567700",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "226 HENDRIE ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482023734",
            "telephone_number": "989-941-6821"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "145 ROCHDALE DR S STE F",
            "city": "ROCHESTER HILLS",
            "state": "MI",
            "postal_code": "483092275",
            "telephone_number": "248-608-4514"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2925 Russell St",
            "address_purpose": "LOCATION",
            "city": "Detroit",
            "state": "MI",
            "postal_code": "482074825",
            "country_code": "US",
            "telephone_number": "133-396-5300",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "226 Hendrie St",
            "address_purpose": "LOCATION",
            "city": "Detroit",
            "state": "MI",
            "postal_code": "482023734",
            "country_code": "US",
            "telephone_number": "201-968-6934",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JAYAWARDENA",
        "first_name": "NISHANI",
        "credential": "LPC, NCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-16",
        "last_updated": "2022-06-11",
        "certification_date": "2022-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MI",
            "license": "6401222279",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester Hills, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2022; 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.