Active NPI
Ava Stephens
- Mental Health Counselor
- Detroit, MI
National Provider Identifier
1861825218
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 6803086555
- Practice address
- 2925 Russell St
Detroit, MI 48207-4825 - Phone
- (313) 396-5300
- NPI assigned
- Aug 20, 2013
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 6803086555 | MI | Primary |
Addresses
Primary practice location
2925 Russell St
Detroit, MI 48207-4825
Mailing address
2925 Russell Street
Team Mental Health Services
Detroit, MI 48207
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 171M00000X | Other | MI | CARE COORDINATOR |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6803086555 | MI | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Team Wellness Center | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Community Health Clinic/Center
- Detroit, MI
- NPI 1588855100
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1376956800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1376956800000",
"number": "1861825218",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2925 RUSSELL STREET",
"address_2": "TEAM MENTAL HEALTH SERVICES",
"city": "DETROIT",
"state": "MI",
"postal_code": "48207"
},
{
"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": "313-396-5300"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STEPHENS",
"first_name": "AVA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-08-20",
"last_updated": "2013-08-20",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "MI",
"license": "6803086555",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CARE COORDINATOR",
"identifier": "171M00000X",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Detroit, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.