Active NPI
Ignite 3 LLC
- Clinical Psychologist
- Roseville, MI
National Provider Identifier
1891360269
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- Legal business name
- IGNITE 3 LLC
- Practice address
- 28491 Utica Rd
Roseville, MI 48066-2593 - Phone
- (352) 552-5686
- NPI assigned
- May 26, 2021
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Lisa Brooks, LLP
- Title
- Owner
- Phone
- (352) 552-5686
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | Primary |
Addresses
Primary practice location
28491 Utica Rd
Roseville, MI 48066-2593
Mailing address
28491 Utica Rd
Roseville, MI 48066-2593
Phone (352) 552-5686
National Provider Directory
National Provider DirectoryLocations
28491 Utica Rd
Roseville, MI 48066
Phone (352) 552-5686
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1621987200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1621987200000",
"number": "1891360269",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "28491 UTICA RD",
"city": "ROSEVILLE",
"state": "MI",
"postal_code": "480662593",
"telephone_number": "352-552-5686"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "28491 UTICA RD",
"city": "ROSEVILLE",
"state": "MI",
"postal_code": "480662593",
"telephone_number": "352-552-5686"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "IGNITE 3 LLC",
"organizational_subpart": "NO",
"enumeration_date": "2021-05-26",
"last_updated": "2021-05-26",
"certification_date": "2021-05-26",
"status": "A",
"authorized_official_last_name": "BROOKS",
"authorized_official_first_name": "LISA",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "352-552-5686",
"authorized_official_credential": "LLP"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Psychologist, Clinical",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Roseville, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.