Active NPI
Sanyani D Edwards, TLLP
- Psychologist
- Southfield, MI
National Provider Identifier
1124351200
On this page
OIG exclusion record
The HHS Office of Inspector General’s List of Excluded Individuals/Entities (LEIE) contains a record with this NPI:
- Section 1128a(1) exclusion effective Jul 20, 2014.
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 6301014230
- Practice address
- 25438 Saint James
Southfield, MI 48075-1247 - Phone
- (313) 215-0545
- NPI assigned
- Sep 8, 2009
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 6301014230 | MI | Primary |
Addresses
Primary practice location
25438 Saint James
Southfield, MI 48075-1247
Mailing address
PO Box 44446
Detroit, MI 48244-0446
Phone (313) 215-0545
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
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6301014230 | MI | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1252368000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1252368000000",
"number": "1124351200",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 44446",
"city": "DETROIT",
"state": "MI",
"postal_code": "482440446",
"telephone_number": "313-215-0545"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "25438 SAINT JAMES",
"city": "SOUTHFIELD",
"state": "MI",
"postal_code": "480751247",
"telephone_number": "313-215-0545"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EDWARDS",
"first_name": "SANYANI",
"middle_name": "D",
"credential": "TLLP",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2009-09-08",
"last_updated": "2009-09-08",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "MI",
"license": "6301014230",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Southfield, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.