Kumbirai Kambasha

Individual provider Active NPI Professional Counselor · Lansing, MI

NPI 1710644752 · NPPES record last updated Oct 31, 2024

Key facts

NPI
1710644752
Entity type
Individual (NPI type 1)
Primary specialty
Professional Counselor 101YP2500X
License
6451021949 (MI)
Practice address
2708 Senate Dr Apt B101
Lansing, MI 48912-4482
Phone
(517) 927-3452
NPI assigned
Nov 24, 2021
Sex
Male
Sole proprietor
No

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 and National Provider Directory roles.

Medicare Care Compare profile

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

Medicare participation

Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No

Medicare enrollment records

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

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
6451021949MIMDProfessional Counselor

Practice roles

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

Specialties & licenses

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

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

Other providers in Lansing, MI

All providers in Lansing, MI · Professional Counselor in Michigan

Sources for this page

Verify at the official NPI Registry.