Active NPI
Lilac Kenner
- Marriage & Family Therapist
- Novi, MI
National Provider Identifier
1245761600
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 120832
- Practice address
- 41521 W 11 Mile Rd
Novi, MI 48375-1803 - Phone
- (248) 299-0030
- NPI assigned
- Mar 27, 2017
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | |||
| Other Technician | 247200000X | |||
| Marriage & Family Therapist | 106H00000X | 120832 | CA | Primary |
Addresses
Primary practice location
41521 W 11 Mile Rd
Novi, MI 48375-1803
Mailing address
41521 W 11 Mile Rd
Novi, MI 48375-1803
Phone (248) 299-0030
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 |
|---|---|---|---|
| 120832 | CA | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1490572800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1597104000000",
"number": "1245761600",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "41521 W 11 MILE RD",
"city": "NOVI",
"state": "MI",
"postal_code": "483751803",
"telephone_number": "248-299-0030"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "41521 W 11 MILE RD",
"city": "NOVI",
"state": "MI",
"postal_code": "483751803",
"telephone_number": "248-299-0030"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KENNER",
"first_name": "LILAC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-03-27",
"last_updated": "2020-08-11",
"certification_date": "2020-08-11",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": null,
"license": null,
"primary": false
},
{
"code": "247200000X",
"taxonomy_group": "",
"desc": "Technician, Other",
"state": null,
"license": null,
"primary": false
},
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "120832",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Novi, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.