Individual provider Active NPI

Pamela Hargrove, LLPC

  • Counselor
  • Redford, MI
National Provider Identifier
1669902987
Registry record updated Mar 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
6401017132 Issued in MI
Practice address
9315 Telegraph Rd
Redford, MI 48239-1260
Phone
(313) 450-4500
Fax
(313) 450-4812
NPI assigned
Jun 19, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X
Counselor 101Y00000X 6401017132 MI Primary

Addresses

Primary practice location

9315 Telegraph Rd
Redford, MI 48239-1260

Mailing address

9315 Telegraph Rd
Redford, MI 48239-1260
Phone (313) 450-4500

Other identifiers 1

IdentifierTypeStateIssuer
6401017132MedicaidMI

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
6401017132MIMDCounselor

NPI Registry JSON

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

{
    "created_epoch": "1497830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646179200000",
    "number": "1669902987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9315 TELEGRAPH RD",
            "city": "REDFORD",
            "state": "MI",
            "postal_code": "482391260",
            "telephone_number": "313-450-4500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9315 TELEGRAPH RD",
            "city": "REDFORD",
            "state": "MI",
            "postal_code": "482391260",
            "telephone_number": "313-450-4500",
            "fax_number": "313-450-4812"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARGROVE",
        "first_name": "PAMELA",
        "credential": "LLPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-19",
        "last_updated": "2022-03-02",
        "certification_date": "2021-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "MI",
            "license": "6401017132",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6401017132",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Redford, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2022; 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.