Active NPI
Lourdes Corinne Fonseca-Nearon, LLPC
- Counselor
- Troy, MI
National Provider Identifier
1245001882
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- 6451023476
- Practice address
- 215 E Big Beaver Rd Ste 100
Troy, MI 48083-1216 - Phone
- (313) 451-3315
- NPI assigned
- Jan 11, 2024
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Counselor | 101Y00000X | 6451023476 | MI | Primary |
Addresses
Primary practice location
215 E Big Beaver Rd Ste 100
Troy, MI 48083-1216
Mailing address
23730 Rowe St
Dearborn, MI 48124-1631
Phone (313) 282-1340
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
| License | State | Type | Specialty |
|---|---|---|---|
| 6451023476 | MI | MD | Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Maples Creative Counseling LLC | Counselor | Current | Accepting new patients |
Locations
2835 Bagley St
Ste 825
Detroit, MI 48216
Phone (313) 451-3315
215 E Big Beaver Rd
Ste 100
Troy, MI 48083
Phone (313) 451-3315
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1704931200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1704931200000",
"number": "1245001882",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "23730 ROWE ST",
"city": "DEARBORN",
"state": "MI",
"postal_code": "481241631",
"telephone_number": "313-282-1340"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "215 E BIG BEAVER RD STE 100",
"city": "TROY",
"state": "MI",
"postal_code": "480831216",
"telephone_number": "313-451-3315"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FONSECA-NEARON",
"first_name": "LOURDES",
"middle_name": "CORINNE",
"credential": "LLPC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-01-11",
"last_updated": "2024-01-11",
"certification_date": "2024-01-11",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "MI",
"license": "6451023476",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Troy, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 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.