Fejiro Evwaraye

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

6362010029 Issued in MI

Practice address

1760 S Telegraph Rd Ste 103&240
Bloomfield Hills, MI 48302-0180

Phone

(248) 256-5209

NPI assigned

Aug 16, 2024

Last updated

Nov 22, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1723766400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732233600000",
    "number": "1710719844",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7414 KIPLING ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482062679",
            "telephone_number": "810-445-8382"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1760 S TELEGRAPH RD STE 103&240",
            "city": "BLOOMFIELD HILLS",
            "state": "MI",
            "postal_code": "483020180",
            "telephone_number": "248-256-5209"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1150 East Jefferson",
            "address_purpose": "LOCATION",
            "city": "Detroit",
            "state": "MI",
            "postal_code": "48214",
            "country_code": "US",
            "telephone_number": "810-445-8382",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EVWARAYE",
        "first_name": "FEJIRO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-08-16",
        "last_updated": "2024-11-22",
        "certification_date": "2024-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MI",
            "license": "6362010029",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Counselor in Bloomfield Hills, MI
• Providers in Bloomfield Hills, MI by specialty
• Mental Health Counselor in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2024; 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.