Active NPI
The Great Divine Center LLC
- Mental Health Counselor
- Detroit, MI
National Provider Identifier
1902558091
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- Legal business name
- THE GREAT DIVINE CENTER LLC
- Practice address
- 17169 E Warren Ave
Detroit, MI 48224-2279 - Phone
- (313) 480-4766
- NPI assigned
- Jan 20, 2022
- 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
- Kymaletha Brown, LLPC
- Title
- Counselor/Owner
- Phone
- (313) 480-4766
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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | Primary | ||
| Community Health Clinic/Center | 261QC1500X | |||
| Multi-Specialty Clinic/Center | 261QM1300X |
Addresses
Primary practice location
17169 E Warren Ave
Detroit, MI 48224-2279
Mailing address
17163 E Warren Ave
Detroit, MI 48224-2279
Phone (313) 480-4766
National Provider Directory
National Provider DirectoryPractitioners & 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": "1642636800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1642636800000",
"number": "1902558091",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17163 E WARREN AVE",
"city": "DETROIT",
"state": "MI",
"postal_code": "482242279",
"telephone_number": "313-480-4766"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17169 E WARREN AVE",
"city": "DETROIT",
"state": "MI",
"postal_code": "482242279",
"telephone_number": "313-480-4766"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "THE GREAT DIVINE CENTER LLC",
"organizational_subpart": "NO",
"enumeration_date": "2022-01-20",
"last_updated": "2022-01-20",
"certification_date": "2022-01-08",
"status": "A",
"authorized_official_last_name": "BROWN",
"authorized_official_first_name": "KYMALETHA",
"authorized_official_title_or_position": "COUNSELOR/OWNER",
"authorized_official_telephone_number": "313-480-4766",
"authorized_official_credential": "LLPC"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": true
},
{
"code": "261QC1500X",
"taxonomy_group": "",
"desc": "Clinic/Center, Community Health",
"state": null,
"license": null,
"primary": false
},
{
"code": "261QM1300X",
"taxonomy_group": "",
"desc": "Clinic/Center, Multi-Specialty",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Detroit, MI
- The Detroit Recovery Project, Inc
- The Dr. Albert B. Cleage, Sr. Memorial Health Center
- The Friends U Need
- The Giuseppe House LLC
- The Golden Room Children'S Mental Health Services, LLC.
- The Guidance Center
- The H2O Agency LLC
- The Healing Girl
- The Health Team Inc.
- The Hemophila Thrombophilia Treatment Center
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.