Organization Active NPI

Eye-Dent-Ity Project PLLC

  • Professional Counselor
  • Detroit, MI
National Provider Identifier
1609720317
Registry record updated Feb 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
Legal business name
EYE-DENT-ITY PROJECT PLLC
Practice address
19659 Riverview St
Detroit, MI 48219-1622
Phone
(248) 579-3609
NPI assigned
Feb 21, 2026
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2026

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

Authorized official

Name
Eugene McDonald, MA, CRC, LPCNPI 1770119091
Title
Clinical Director/LPC
Phone
(248) 579-3609

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
Professional CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YP2500X Primary

Addresses

Primary practice location

19659 Riverview St
Detroit, MI 48219-1622

Mailing address

19659 Riverview St
Detroit, MI 48219-1622
Phone (248) 579-3609

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20260326000590 MI Part B Supplier - Clinic/Group Practice 0547745770 Receives reassigned benefits from 1 practitioner
Practice locations: Detroit, MI

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1771632000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1771632000000",
    "number": "1609720317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19659 RIVERVIEW ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482191622",
            "telephone_number": "248-579-3609"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19659 RIVERVIEW ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482191622",
            "telephone_number": "248-579-3609"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EYE-DENT-ITY PROJECT PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-02-21",
        "last_updated": "2026-02-21",
        "certification_date": "2026-02-21",
        "status": "A",
        "authorized_official_last_name": "MCDONALD",
        "authorized_official_first_name": "EUGENE",
        "authorized_official_title_or_position": "CLINICAL DIRECTOR/LPC",
        "authorized_official_telephone_number": "248-579-3609",
        "authorized_official_credential": "MA, CRC, LPC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "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 Feb 21, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.