Active NPI
Kenneth Whittum
- Professional Counselor
- Livonia, MI
National Provider Identifier
1497132633
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 6401013328
- Practice address
- 38828 Grandon St
Livonia, MI 48150-3381 - Phone
- (734) 368-4571
- NPI assigned
- Apr 27, 2015
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 6401013328 | MI | Primary |
Addresses
Primary practice location
38828 Grandon St
Livonia, MI 48150-3381
Mailing address
38828 Grandon St
Livonia, MI 48150-3381
Phone (734) 368-4571
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 |
|---|---|---|---|
| 6401013328 | MI | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Soulstice Counseling, LLC | Past | Accepting new patients | |
| Soulstice Counseling | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Community/Behavioral Health Agency
- Livonia, MI
- NPI 1245623057
-
- Community/Behavioral Health Agency
- Plymouth, MI
- NPI 1598361727
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1430092800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1430092800000",
"number": "1497132633",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "38828 GRANDON ST",
"city": "LIVONIA",
"state": "MI",
"postal_code": "481503381",
"telephone_number": "734-368-4571"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "38828 GRANDON ST",
"city": "LIVONIA",
"state": "MI",
"postal_code": "481503381",
"telephone_number": "734-368-4571"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WHITTUM",
"first_name": "KENNETH",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2015-04-27",
"last_updated": "2015-04-27",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "MI",
"license": "6401013328",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Livonia, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.