Iesha Odum, MS, CAADC, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

6401013850 Issued in MI

Practice address

2925 Russell St
Detroit, MI 48207-4825

Phone

(248) 747-2798

NPI assigned

Aug 27, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

Practice roles

Locations

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.

• Easterseals Morc Health Care, Inc.

  • Psychiatry Physician
  • Auburn Hills, MI
  • NPI 1376526616
  Medicare reassignment NPD
• Team Wellness Center

  • Community Health Clinic/Center
  • Detroit, MI
  • NPI 1588855100
  Medicare reassignment NPD
• Team Mental Health Services Inc.

  • Primary Care Clinic/Center
  • Detroit, MI
  • NPI 1295324291
  NPD
• Team Mental Health Services Inc.

  • Dentist
  • Detroit, MI
  • NPI 1306383252
  NPD (past)

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

{
    "created_epoch": "1377561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717027200000",
    "number": "1689008609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2925 RUSSELL ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482074825",
            "telephone_number": "313-396-5300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2925 RUSSELL ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482074825",
            "telephone_number": "248-747-2798"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ODUM",
        "first_name": "IESHA",
        "name_prefix": "Ms.",
        "credential": "MS, CAADC, LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-08-27",
        "last_updated": "2024-05-30",
        "certification_date": "2024-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MI",
            "license": "6401013850",
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "MI",
            "license": "6401013850",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• William Oddo, CRNA
• Marquitta Odell
• Yemisi Odetoyinbo, LMSW
• Odicare PC
• Tanya Odisho, D.O.
• Ama Ofosu-Appiah, DDS
• Kaodichinma Ogbonna
• Doris D Ogburn, RDH
• Kamdili Nnadebem Ogbutor
• Herbert Luke Ogden, MD

• Professional Counselor in Detroit, MI
• Providers in Detroit, MI by specialty
• Professional Counselor in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.