Active NPI
Audrey Hendricks
- Addiction (Substance Use Disorder) Counselor
- Detroit, MI
National Provider Identifier
1467945279
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- Practice address
- 9605 Grand River Ave
Detroit, MI 48204-2139 - Phone
- (313) 834-5930
- NPI assigned
- Jun 7, 2018
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | Primary |
Addresses
Primary practice location
9605 Grand River Ave
Detroit, MI 48204-2139
Mailing address
30145 Lacy Dr
Westland, MI 48186-7351
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
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Nardin Park Recovery Center,Inc. | Single Specialty | Past | 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": "1528329600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1528329600000",
"number": "1467945279",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "30145 LACY DR",
"city": "WESTLAND",
"state": "MI",
"postal_code": "481867351"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9605 GRAND RIVER AVE",
"city": "DETROIT",
"state": "MI",
"postal_code": "482042139",
"telephone_number": "313-834-5930"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HENDRICKS",
"first_name": "AUDREY",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-06-07",
"last_updated": "2018-06-07",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"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 Jun 7, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.