Individual provider Active NPI

Charlotte Yvonne Overall

  • Community/Behavioral Health Agency
  • Detroit, MI
National Provider Identifier
1356988562
Registry record updated Dec 6, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Practice address
13334 Longview St
Detroit, MI 48213-1919
Phone
(313) 544-8695
NPI assigned
Dec 6, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 6, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

13334 Longview St
Detroit, MI 48213-1919

Mailing address

13334 Longview St
Detroit, MI 48213-1919
Phone (313) 544-8695

Other practice location 1

5090 Nottingham Rd
Detroit, MI 48224-3131
Phone (313) 544-8695

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

Practice roles

OrganizationSpecialtyStatusNew patients
Overall Care Supported Services Current Accepting new patients

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": "1575590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1575590400000",
    "number": "1356988562",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13334 LONGVIEW ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482131919",
            "telephone_number": "313-544-8695"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13334 LONGVIEW ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482131919",
            "telephone_number": "313-544-8695"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5090 Nottingham Rd",
            "address_purpose": "LOCATION",
            "city": "Detroit",
            "state": "MI",
            "postal_code": "482243131",
            "country_code": "US",
            "telephone_number": "313-544-8695",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OVERALL",
        "first_name": "CHARLOTTE",
        "middle_name": "YVONNE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-12-06",
        "last_updated": "2019-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "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 Dec 6, 2019; 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.