Individual provider Active NPI

Thalese McClendon, DOULA

  • Doula
  • Warren, MI
National Provider Identifier
1639069644
Registry record updated Jul 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
DoulaTaxonomy code 374J00000X
Practice address
21079 Waltham Rd
Warren, MI 48089-3247
Phone
(586) 443-0004
Fax
(586) 443-0004
NPI assigned
Jul 9, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Doula 374J00000X MI Primary

Addresses

Primary practice location

21079 Waltham Rd
Warren, MI 48089-3247

Mailing address

21079 Waltham Rd
Warren, MI 48089-3247
Phone (586) 443-0004

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

NPI Registry JSON

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

{
    "created_epoch": "1752019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752019200000",
    "number": "1639069644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21079 WALTHAM RD",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480893247",
            "telephone_number": "586-443-0004",
            "fax_number": "586-443-0004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21079 WALTHAM RD",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480893247",
            "telephone_number": "586-443-0004",
            "fax_number": "586-443-0004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCLENDON",
        "first_name": "THALESE",
        "credential": "DOULA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-07-09",
        "last_updated": "2025-07-09",
        "certification_date": "2025-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "374J00000X",
            "taxonomy_group": "",
            "desc": "Doula",
            "state": "MI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Warren, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2025; 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.