Active NPI
Adolphus Heath
- Professional Counselor
- Detroit, MI
National Provider Identifier
1619225562
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 820123
- Practice address
- 2081 W Grand Blvd
Detroit, MI 48208-1105 - Phone
- (313) 895-0500
- NPI assigned
- Aug 27, 2012
- Sex
- Male
- Sole proprietor
- No
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 | 820123 | MI | Primary |
Addresses
Primary practice location
2081 W Grand Blvd
Detroit, MI 48208-1105
Mailing address
6385 Radnor St
Detroit, MI 48224-1261
Phone (313) 283-6956
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 820123 | Medicaid | MI |
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 |
|---|---|---|---|
| 820123 | MI | MD | Addiction (Substance Use Disorder) Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sobriety House | 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.
-
- Substance Abuse Rehabilitation Facility
- Detroit, MI
- NPI 1386777555
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1346025600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1346025600000",
"number": "1619225562",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6385 RADNOR ST",
"city": "DETROIT",
"state": "MI",
"postal_code": "482241261",
"telephone_number": "313-283-6956"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2081 W GRAND BLVD",
"city": "DETROIT",
"state": "MI",
"postal_code": "482081105",
"telephone_number": "313-895-0500"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HEATH",
"first_name": "ADOLPHUS",
"name_prefix": "Mr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-08-27",
"last_updated": "2012-08-27",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "MI",
"license": "820123",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "820123",
"state": "MI"
}
],
"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 Aug 27, 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.