Individual provider Active NPI

Carlos T League

  • Addiction (Substance Use Disorder) Counselor
  • Detroit, MI
National Provider Identifier
1578818837
Registry record updated Jul 23, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
DEVELOPMENTPLAN Issued in MI
Practice address
445 Ledyard St
Detroit, MI 48201-2641
Phone
(313) 962-9446
Fax
(313) 962-6395
NPI assigned
Jul 23, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X DEVELOPMENTPLAN MI Primary

Addresses

Primary practice location

445 Ledyard St
Detroit, MI 48201-2641

Mailing address

445 Ledyard St
Detroit, MI 48201-2641
Phone (313) 962-9446

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

LicenseStateTypeSpecialty
DEVELOPMENTPLANMIMDAddiction (Substance Use Disorder) Counselor

NPI Registry JSON

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

{
    "created_epoch": "1343001600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1343001600000",
    "number": "1578818837",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "445 LEDYARD ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482012641",
            "telephone_number": "313-962-9446",
            "fax_number": "313-962-6395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "445 LEDYARD ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482012641",
            "telephone_number": "313-962-9446",
            "fax_number": "313-962-6395"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEAGUE",
        "first_name": "CARLOS",
        "middle_name": "T",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-07-23",
        "last_updated": "2012-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MI",
            "license": "DEVELOPMENTPLAN",
            "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 Jul 23, 2012; 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.