Individual provider Active NPI

Dalynngia Fuqua, LLPC

  • Counselor
  • Canton, MI
National Provider Identifier
1114767977
Registry record updated May 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
6451023585 Issued in MI
Practice address
40315 Michigan Ave
Canton, MI 48188-2908
Phone
(313) 363-1696
Fax
(734) 544-1084
NPI assigned
May 29, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 29, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
School Counselor 101YS0200X SC0000001155536 MI
Counselor 101Y00000X 6451023585 MI Primary

Addresses

Primary practice location

40315 Michigan Ave
Canton, MI 48188-2908

Mailing address

1258 Berkshire St
Westland, MI 48186-5369
Phone (734) 882-0858

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
6451023585MIMDCounselor
SC0000001155536MIMDSchool Counselor

NPI Registry JSON

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

{
    "created_epoch": "1716940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716940800000",
    "number": "1114767977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1258 BERKSHIRE ST",
            "city": "WESTLAND",
            "state": "MI",
            "postal_code": "481865369",
            "telephone_number": "734-882-0858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40315 MICHIGAN AVE",
            "city": "CANTON",
            "state": "MI",
            "postal_code": "481882908",
            "telephone_number": "313-363-1696",
            "fax_number": "734-544-1084"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FUQUA",
        "first_name": "DALYNNGIA",
        "credential": "LLPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-05-29",
        "last_updated": "2024-05-29",
        "certification_date": "2024-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YS0200X",
            "taxonomy_group": "",
            "desc": "Counselor, School",
            "state": "MI",
            "license": "SC0000001155536",
            "primary": false
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "MI",
            "license": "6451023585",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canton, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2024; 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.