Individual provider Active NPI

Sharae Lacrasha Hill

  • Adult Development & Aging Psychologist
  • Detroit, MI
National Provider Identifier
1962045245
Registry record updated Oct 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Development & Aging PsychologistTaxonomy code 103TA0700X
Practice address
15920 Fenkell St
Detroit, MI 48227-1970
Phone
(313) 220-2255
NPI assigned
Oct 19, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 19, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Development & Aging Psychologist 103TA0700X Primary

Addresses

Primary practice location

15920 Fenkell St
Detroit, MI 48227-1970

Mailing address

4291 Wendell Rd
West Bloomfield, MI 48323-3266
Phone (313) 220-2255

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": "1571443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571443200000",
    "number": "1962045245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4291 WENDELL RD",
            "city": "WEST BLOOMFIELD",
            "state": "MI",
            "postal_code": "483233266",
            "telephone_number": "313-220-2255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15920 FENKELL ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482271970",
            "telephone_number": "313-220-2255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HILL",
        "first_name": "SHARAE",
        "middle_name": "LACRASHA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-10-19",
        "last_updated": "2019-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TA0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Adult Development & Aging",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Oct 19, 2019; 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.