MR. SHELBY QUALLS (NPI# 1194847749) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1194847749 |
| Entity Type | Individual |
| Full Name | MR. SHELBY QUALLS |
| Credential | CAC-1 |
| Practice Address |
8809 John C Lodge Detroit MI 48224 |
| Mailing Address |
10520 Morang Dr Detroit MI 48224-1840 |
| Practice Telephone | 3138876737 |
| Practice Fax Number | 3138760532 |
| Mailing Telephone | 3136408084 |
| Enumeration Date | 2007-04-04 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
820080 | MI | Behavioral Health & Social Service Providers |
| Street Address |
8809 JOHN C LODGE |
| City | DETROIT |
| State | MI |
| Zip Code | 48224 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326169186 | Charllotte Densmore | Counselor | 8809 John C Lodge, Bldg. #5, Detroit, MI 48202 | 2007-04-02 |
| 1124226618 | Lisa Denette Woods | Counselor | 8809 John C Lodge, Detroit, MI 48202 | 2007-07-05 |
| 1386850501 | Tina Adele Johnson | Registered Nurse | 8809 John C Lodge, Detroit, MI 48202 | 2007-05-15 |
| 1235250093 | Florence Una-marie Arrington | Counselor | 8809 John C Lodge, Detroit, MI 48202 | 2007-04-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508403767 | Renia Scott | Licensed Practical Nurse | 5211 Berkshire St, Detroit, MI 48224 | 2019-12-06 |
| 1063928612 | Edith Neely-harris | Registered Nurse | 1203 Courville Street, Detroit, MI 48224 | 2017-12-19 |
| 1043767585 | Annette Jackson | Counselor | 10666 Duprey St, Detroit, MI 48224 | 2016-09-01 |
| 1164977807 | Dehvin White-peck | Technician, Other | 4529 Harvard Rd, Detroit, MI 48224 | 2016-08-23 |
| 1992153704 | Andrea Henderson | Licensed Practical Nurse | 9131 Bradford, Detroit, MI 48224 | 2016-06-02 |
| 1467807578 | Venus Staffing LLC | Nursing Care | 5601 Devonshire Rd, Detroit, MI 48224 | 2016-04-26 |
| 1558795625 | Rafia El-alayli | Internal Medicine | 9901 Whittier Ave, Detroit, MI 48224 | 2013-08-26 |
| 1831334259 | House of Hearts Ministry, Inc. | Voluntary or Charitable | 11151 Worden, Detroit, MI 48224 | 2008-12-15 |
| 1992994636 | Lilian Lai Md PC | Clinic/Center | 15850 E Warren Ave, Detroit, MI 48224 | 2007-10-18 |
| 1184845844 | Tymon C Totte | Dentist | 17700 Mack Ave, Great Expressions Dental Centers, Gross Pointe, MI 48224 | 2007-05-01 |
| Find all providers in zip 48224 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386251841 | Diversified Community Services | Counselor | 10301 W 7 Mile Rd, Detroit, MI 48221-1962 | 2020-09-29 |
| 1750907853 | Ronnie Stephen | Counselor | 15025 Fenkell St, Detroit, MI 48227-2647 | 2020-06-24 |
| 1144860552 | Allen Hugh Warrick IIi | Counselor | 9605 Grand River Ave # A, Detroit, MI 48204-2139 | 2020-01-14 |
| 1396309878 | Darnesha Coy | Counselor | 17870 Dresden St, Detroit, MI 48205-3138 | 2019-04-30 |
| 1518438746 | Curron Thomas | Counselor | 16850 Wyoming St, Apartment 328, Detroit, MI 48221-3415 | 2018-12-16 |
| 1861962094 | Reid Talley | Counselor | 12010 Elmhurst, Detroit, MI 48206 | 2018-11-30 |
| 1205304359 | Life Challenge of Southeastern Michigan | Counselor | 17667 Pierson St, Detroit, MI 48219-2520 | 2018-11-07 |
| 1598233892 | Michigan Employment & Training Plus | Counselor | 6522 Piedmont St, Detroit, MI 48228-4950 | 2018-11-05 |
| 1821588773 | Avery Brown Jr. | Counselor | 8333 Townsend St, Detroit, MI 48213-2331 | 2018-05-16 |
| 1538669304 | Helping Hands Community Centers 1 | Counselor | 2434 Chicago Blvd, Detroit, MI 48206-1741 | 2018-02-17 |
| Find all providers in DETROIT | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.