Jennifer Prantera, LPC

Primary specialty

CounselorTaxonomy code 101Y00000X

License

6401010796 Issued in MI

Practice address

45863 Waterside Dr Apt 9311
Macomb, MI 48044-5340

Phone

(158) 694-6759

NPI assigned

Jun 15, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Richard Kneip, PH.D., P.C.

  dba Great Lakes Psychology Group

  • Community/Behavioral Health Agency
  • Clarkston, MI
  • NPI 1679739700
  Medicare reassignment NPD

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

{
    "created_epoch": "1529020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529020800000",
    "number": "1508350323",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45863 WATERSIDE DR APT 9311",
            "city": "MACOMB",
            "state": "MI",
            "postal_code": "480445340",
            "telephone_number": "158-694-6759"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45863 WATERSIDE DR APT 9311",
            "city": "MACOMB",
            "state": "MI",
            "postal_code": "480445340",
            "telephone_number": "158-694-6759"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRANTERA",
        "first_name": "JENNIFER",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-15",
        "last_updated": "2018-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "MI",
            "license": "6401010796",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Deanna M Poniatowski, D.D.S.
• Rafaa Sameer Poota, RDH
• Tina Marie Porta, COTAL
• Raquel Potter
• Richard Henry Poupard, DDS
• Cecilly A Pratt, MD
• Precision Surgery Center, LLC
• Premier at Home Hospice & Palliative Care L.L.C
• Premier Foot & Ankle PLLC
• Premier Senior Home Care L.L.C (Premier Senior Home Care)

• Counselor in Macomb, MI
• Providers in Macomb, MI by specialty
• Counselor in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.