Active NPI
Lasondra Wayne
- Mental Health Counselor
- Portage, MI
National Provider Identifier
1881967909
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 6301015047
- Practice address
- 7320 Garden LN
Suite 106
Portage, MI 49002-4423 - Phone
- (269) 612-4432
- NPI assigned
- Feb 21, 2012
- Last updated
- Feb 21, 2012
- Sex
- Female
- Sole proprietor
- No
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 | 6301015047 | MI | Primary |
Addresses
Primary practice location
7320 Garden LN
Suite 106
Portage, MI 49002-4423
Mailing address
7320 Garden LN
Suite 106
Portage, MI 49002-4423
Phone (269) 612-4432
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 |
|---|---|---|---|
| 6301015047 | MI | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1329782400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1329782400000",
"number": "1881967909",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7320 GARDEN LN",
"address_2": "SUITE 106",
"city": "PORTAGE",
"state": "MI",
"postal_code": "490024423",
"telephone_number": "269-612-4432"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7320 GARDEN LN",
"address_2": "SUITE 106",
"city": "PORTAGE",
"state": "MI",
"postal_code": "490024423",
"telephone_number": "269-612-4432"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WAYNE",
"first_name": "LASONDRA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-02-21",
"last_updated": "2012-02-21",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "MI",
"license": "6301015047",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Portage, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.