NPIMap

Organization Active NPI

Restore Me, LLC

  • Mental Health Counselor
  • Detroit, MI
National Provider Identifier
1386255032
Registry record updated Aug 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
RESTORE ME, LLC
Practice address
17836 Chandler Park Dr
Detroit, MI 48224-1340
Phone
(919) 332-4043
NPI assigned
Aug 14, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2020

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

Authorized official

Name
Krystal SmithNPI 1366775371
Title
Clinical Social Worker, Owner
Phone
(919) 332-4043

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X Primary

Addresses

Primary practice location

17836 Chandler Park Dr
Detroit, MI 48224-1340

Mailing address

PO Box 361113
Grosse Pointe, MI 48236-5113
Phone (919) 332-4043

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1597363200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1597363200000",
    "number": "1386255032",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 361113",
            "city": "GROSSE POINTE",
            "state": "MI",
            "postal_code": "482365113",
            "telephone_number": "919-332-4043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17836 CHANDLER PARK DR",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482241340",
            "telephone_number": "919-332-4043"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RESTORE ME, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-08-14",
        "last_updated": "2020-08-14",
        "certification_date": "2020-08-14",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "KRYSTAL",
        "authorized_official_title_or_position": "CLINICAL SOCIAL WORKER, OWNER",
        "authorized_official_telephone_number": "919-332-4043"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental 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 Aug 14, 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.

Verify at the official NPI Registry.