Four Corners

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

FOUR CORNERS

Practice address

15798 Livernois Ave
Detroit, MI 48238

Phone

(248) 495-8985

Fax

(248) 719-7595

NPI assigned

Apr 28, 2014

Organization subpart

No

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

Authorized official

Name

Karicia Regene Carter

Title

Director

Phone

(248) 495-8985

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1398643200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1398643200000",
    "number": "1124438320",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15798 LIVERNOIS AVE",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "48238",
            "telephone_number": "248-495-8985",
            "fax_number": "248-719-7595"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15798 LIVERNOIS AVE",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "48238",
            "telephone_number": "248-495-8985",
            "fax_number": "248-719-7595"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOUR CORNERS",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-04-28",
        "last_updated": "2014-04-28",
        "status": "A",
        "authorized_official_last_name": "CARTER",
        "authorized_official_first_name": "KARICIA",
        "authorized_official_middle_name": "REGENE",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "248-495-8985"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Counselor in Detroit, MI
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• Mental Health Counselor in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2014; 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.