Ashantae Elizabeth-Jean Kelley

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

Practice address

15025 Fenkell St
Detroit, MI 48227-2647

Phone

(313) 345-4310

NPI assigned

May 4, 2023

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Locations

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.

• Lakeridge Village, Inc.

  • Substance Abuse Rehabilitation Facility
  • Detroit, MI
  • NPI 1144469461
  NPD

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

{
    "created_epoch": "1683158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683158400000",
    "number": "1013606086",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15941 FAIRFIELD ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482384123",
            "telephone_number": "313-345-4310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15025 FENKELL ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482272647",
            "telephone_number": "313-345-4310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLEY",
        "first_name": "ASHANTAE",
        "middle_name": "ELIZABETH-JEAN",
        "name_prefix": "Ms.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-05-04",
        "last_updated": "2023-05-04",
        "certification_date": "2023-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Latasha Keller
• Melissa Renee Keller, PA-C
• Ruston Keller
• Suzanne Lynn Keller, PHD
• Arthur Kelley II
• Audrey Ann Kelley, ADMINISTRATOR
• Charlisa L Kelley
• Christine Kelley
• Danyell Kelley
• Erica M. Kelley, LPC,CRC,LBSW

• Addiction (Substance Use Disorder) Counselor in Detroit, MI
• Providers in Detroit, MI by specialty
• Addiction (Substance Use Disorder) Counselor in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2023; 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.