Faith and Radical Self-Love, LLC

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

FAITH AND RADICAL SELF-LOVE, LLC

Doing business as

Lenoras Light

Practice address

22804 Sharrow Ave
Warren, MI 48089-2882

Phone

(313) 854-5102

Fax

(313) 251-7344

NPI assigned

Sep 11, 2020

Organization subpart

No

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

Authorized official

Name

Zenobia Kindle-Davis

Title

Therapist/Owner

Phone

(313) 854-5102

Specialties & licenses 1

Addresses

Other names 1

• Lenoras Light Doing business as

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

{
    "created_epoch": "1599782400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1643932800000",
    "number": "1205441722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22804 SHARROW AVE",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480892882",
            "telephone_number": "313-854-5102",
            "fax_number": "313-251-7344"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22804 SHARROW AVE",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480892882",
            "telephone_number": "313-854-5102",
            "fax_number": "313-251-7344"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAITH AND RADICAL SELF-LOVE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-11",
        "last_updated": "2022-02-04",
        "certification_date": "2022-02-04",
        "status": "A",
        "authorized_official_last_name": "KINDLE-DAVIS",
        "authorized_official_first_name": "ZENOBIA",
        "authorized_official_title_or_position": "THERAPIST/OWNER",
        "authorized_official_telephone_number": "313-854-5102"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lenoras Light",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Assumpta Ezenwa
• Fadi Ezzeddine
• Michael L Faber, DO
• Pauline Fay Fail II
• Christina R Faita, LMSW, MSW, BA
• Faith Counseling
• Faith Physical Therapy LLC
• Opeyemi Fakayode, MD
• Fall Transportation LLC
• Natasha Lynn Falls, OTRL

• Mental Health Clinic/Center (Including Community Mental Health Center) in Warren, MI
• Providers in Warren, MI by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2022; 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.