Active NPI
Lawrence Kenyatta Sr., BA. CADC
- Addiction (Substance Use Disorder) Counselor
- Detroit, MI
National Provider Identifier
1154700490
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- Practice address
- 3031 W Grand Blvd
Suite 370
Detroit, MI 48202-3046 - Phone
- (313) 456-6006
- Fax
- (313) 935-9311
- NPI assigned
- May 20, 2015
- 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 |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | MI | Primary |
Addresses
Primary practice location
3031 W Grand Blvd
Suite 370
Detroit, MI 48202-3046
Mailing address
3031 W Grand Blvd
Suite 370
Detroit, MI 48202-3046
Phone (313) 456-6006
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1432080000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1432080000000",
"number": "1154700490",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3031 W GRAND BLVD",
"address_2": "SUITE 370",
"city": "DETROIT",
"state": "MI",
"postal_code": "482023046",
"telephone_number": "313-456-6006",
"fax_number": "313-935-9311"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3031 W GRAND BLVD",
"address_2": "SUITE 370",
"city": "DETROIT",
"state": "MI",
"postal_code": "482023046",
"telephone_number": "313-456-6006",
"fax_number": "313-935-9311"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KENYATTA",
"first_name": "LAWRENCE",
"name_prefix": "Mr.",
"name_suffix": "Sr.",
"credential": "BA. CADC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2015-05-20",
"last_updated": "2015-05-20",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "MI",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Detroit, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.