Individual provider Active NPI

Desiree J Neal, CERTIFIED PEER SPECI

  • Peer Specialist
  • Saint Clair Shores, MI
National Provider Identifier
1790484343
Registry record updated Mar 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Peer SpecialistTaxonomy code 175T00000X
Practice address
25401 Harper Ave Ste 2
Saint Clair Shores, MI 48081-2248
Phone
(586) 466-6912
NPI assigned
Mar 2, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 2, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Peer SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 175T00000X Primary

Addresses

Primary practice location

25401 Harper Ave Ste 2
Saint Clair Shores, MI 48081-2248

Mailing address

707 W Milwaukee St # A707W
Detroit, MI 48202-2943
Phone (313) 344-9099

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

NPI Registry JSON

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

{
    "created_epoch": "1677715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677715200000",
    "number": "1790484343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "707 W MILWAUKEE ST # A707W",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482022943",
            "telephone_number": "313-344-9099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25401 HARPER AVE STE 2",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "480812248",
            "telephone_number": "586-466-6912"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEAL",
        "first_name": "DESIREE",
        "middle_name": "J",
        "credential": "CERTIFIED PEER SPECI",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-03-02",
        "last_updated": "2023-03-02",
        "certification_date": "2023-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Peer Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Clair Shores, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2023; 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.