Change Kwesele

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Practice address

411 W Lake Lansing Rd Ste C120
East Lansing, MI 48823-8483

Phone

(517) 215-5217

NPI assigned

Jul 14, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Change Kwesele Malama Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1626220800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626220800000",
    "number": "1053983536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "411 W LAKE LANSING RD STE C120",
            "city": "EAST LANSING",
            "state": "MI",
            "postal_code": "488238483",
            "telephone_number": "517-215-5217"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 W LAKE LANSING RD STE C120",
            "city": "EAST LANSING",
            "state": "MI",
            "postal_code": "488238483",
            "telephone_number": "517-215-5217"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KWESELE",
        "first_name": "CHANGE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-14",
        "last_updated": "2021-07-14",
        "certification_date": "2021-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801106213",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHANGE",
            "last_name": "KWESELE MALAMA",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Kathleen Kurta, MSW
• Richard D Kustasz, D.O.
• Michelle Rayann Kuzma, FNP-BC
• Susan Renee Kuzmanov
• Kimberle Lynn Kwasnick, LLMFT
• Alexander Ky
• Natalie Kyles, LLMSW
• L.E.a.P ABA Therapy, Supervision and Consultation PLLC
• Jolie Labarge
• Amanda Lynn Labo, D.P.T.

• Student in an Organized Health Care Education/Training Program in East Lansing, MI
• Providers in East Lansing, MI by specialty
• Student in an Organized Health Care Education/Training Program in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2021; 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.