Individual provider Active NPI

Kumbirai Kambasha

  • Professional Counselor
  • Lansing, MI
National Provider Identifier
1710644752
Registry record updated Oct 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
6451021949 Issued in MI
Practice address
2708 Senate Dr Apt B101
Lansing, MI 48912-4482
Phone
(517) 927-3452
NPI assigned
Nov 24, 2021
Last updated
Oct 31, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 6451021949 MI
Professional Counselor 101YP2500X 6451021949 MI Primary

Addresses

Primary practice location

2708 Senate Dr Apt B101
Lansing, MI 48912-4482

Mailing address

2708 Senate Dr Apt B101
Lansing, MI 48912-4482
Phone (517) 927-3452

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20240116002729 MI Practitioner - Mental Health Counselor 7618329582 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

8448 Paradise TRL
Carp Lake, MI 49718-9708
Phone (517) 927-3452

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6451021949MIMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Chosen & Anointed Wellness Center Professional CurrentSince Jul 7, 2024 Accepting new patients
A New Day Counseling Consulting and Community Services Counselor CurrentSince Jan 1, 2024 Accepting new patients

Locations

6496 Paradise Trl
Carp Lake, MI 49718

4710 W Saginaw Hwy
Ste 1
Lansing, MI 48917
Phone (517) 816-2800

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1637712000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730332800000",
    "number": "1710644752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2708 SENATE DR APT B101",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489124482",
            "telephone_number": "517-927-3452"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2708 SENATE DR APT B101",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489124482",
            "telephone_number": "517-927-3452"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAMBASHA",
        "first_name": "KUMBIRAI",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-11-24",
        "last_updated": "2024-10-31",
        "certification_date": "2024-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MI",
            "license": "6451021949",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MI",
            "license": "6451021949",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lansing, MI

Sources for this page

Verify at the official NPI Registry.