TERI LAURIE COLVIN (NPI# 1295373504) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295373504 |
| Entity Type | Individual |
| Full Name | TERI LAURIE COLVIN |
| Practice Address |
1852 W Grand Blvd Detroit MI 48208-1006 |
| Practice Telephone | 3138948444 |
| Mailing Telephone | 3138948444 |
| Enumeration Date | 2019-12-17 |
| Last Update Date | 2019-12-17 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 320800000X | Community Based Residential Treatment Facility, Mental Illness | 820174 | MI | Residential Treatment Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | 38-1917278 | 05 |
| Street Address |
1852 W GRAND BLVD |
| City | DETROIT |
| State | MI |
| Zip Code | 48208-1006 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851457451 | Self Help Addiction Rehabilitation (shar) | Substance Abuse Rehabilitation Facility | 1852 W Grand Blvd, Detroit, MI 48208-1006 | 2006-12-28 |
| 1659827301 | Felicia Jackson | Community Health Worker | 1852 W Grand Blvd, Detroit, MI 48208-1006 | 2016-08-31 |
| 1285090886 | Mark Winfield II | Counselor | 1852 W Grand Blvd, Detroit, MI 48208-1006 | 2016-01-12 |
| 1134585003 | Rae Harris | Counselor | 1852 W Grand Blvd, Detroit, MI 48208-1006 | 2016-01-08 |
| 1831555630 | Carolyn Louise Miles | Counselor | 1852 W Grand Blvd, Detroit, MI 48208-1006 | 2016-01-08 |
| 1598121386 | Lawrence Barnes | Counselor | 1852 W Grand Blvd, Detroit, MI 48208-1006 | 2016-01-08 |
| 1396101226 | Tinelda Williamson | Counselor | 1852 W Grand Blvd, Detroit, MI 48208-1006 | 2016-01-07 |
| 1043676968 | Lee Zinsky | Counselor | 1852 W Grand Blvd, Detroit, MI 48208-1006 | 2016-01-07 |
| 1962868893 | Tiffani Holley | Counselor | 1852 W Grand Blvd, Detroit, MI 48208-1006 | 2016-01-07 |
| 1134585045 | Christy Brooks | Counselor | 1852 W Grand Blvd, Detroit, MI 48208-1006 | 2016-01-07 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023616554 | Henry Ford Health System | Pharmacy | 2800 W Grand Blvd, Detroit, MI 48208 | 2020-10-16 |
| 1932645405 | Diane Louise Dodson | Counselor | 5500 Trumbull Apt 315, Detroit, MI 48208 | 2017-01-09 |
| 1164881306 | Cory Eugene Martin | Counselor | 1852 W. Grand Blvd., Detroit, MI 48208 | 2016-02-16 |
| 1578947784 | Hamza Belhaj | Dentist | 2700 Martin Luther King Jr Blvd, Detroit, MI 48208 | 2015-07-17 |
| 1942629167 | Diana Pool | Counselor | 3737 Lawton, Detroit, MI 48208 | 2014-04-15 |
| 1124467048 | Aisha Williams | Social Worker | 4707 Vinewood St., Detroit, MI 48208 | 2013-06-25 |
| 1295079895 | Mia Love | Nurse Practitioner | 2959 Martin Luther King Jr Blvd, Detroit, MI 48208 | 2012-11-20 |
| 1992064356 | Valarie Egeria Foulks | Counselor | 2051 W. Grand Blvd, Detroit, MI 48208 | 2012-05-04 |
| 1023304078 | Ayana Njeri Davis | Massage Therapist | 2550 W. Grand Blvd, Detroit, MI 48208 | 2011-06-28 |
| 1184922627 | Shar Inc. | Community Based Residential Treatment Facility, Mental Illness | 1852 W.grand Blvd, Detroit, MI 48208 | 2011-03-08 |
| Find all providers in zip 48208 | ||||
| Taxonomy Code | 320800000X |
| Grouping | Residential Treatment Facilities |
| Classification | Community Based Residential Treatment Facility, Mental Illness |
| A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750859229 | The Noble Home II, Inc | Community Based Residential Treatment Facility, Mental Illness | 327 E Grand Blvd, Detroit, MI 48207-3616 | 2018-11-02 |
| 1679048870 | Neighborhood Living Services,inc. | Community Based Residential Treatment Facility, Mental Illness | 23001 Norfolk St, Detroit, MI 48219-1185 | 2018-10-04 |
| 1851875371 | People Community of Michigan Afc Homes, Inc. | Community Based Residential Treatment Facility, Mental Illness | 16829 Monica St, Detroit, MI 48221-2969 | 2018-09-20 |
| 1083169502 | Emmanuel House | Community Based Residential Treatment Facility, Mental Illness | 14750 Saint Marys St, Detroit, MI 48227-1862 | 2016-08-25 |
| 1407234586 | Karen Frederick LLC | Community Based Residential Treatment Facility, Mental Illness | 5781 Beaconsfield St, Detroit, MI 48224-3157 | 2015-05-11 |
| 1861882821 | Inclusive Solutions LLC | Community Based Residential Treatment Facility, Mental Illness | 4535 Chrysler Dr, Detroit, MI 48201-1954 | 2015-01-29 |
| 1306257852 | Victory Unto Salvation Faith Ministries Dba The Philip House Mission | Community Based Residential Treatment Facility, Mental Illness | 18066 James Couzens Fwy, 2305 Pasadena, Detroit, MI 48235-2646 | 2014-05-17 |
| 1437586039 | Read All About It Literacy Center | Community Based Residential Treatment Facility, Mental Illness | 2727 Second Ave Suite 124, Detroit, MI 48201-4025 | 2013-09-27 |
| 1184922627 | Shar Inc. | Community Based Residential Treatment Facility, Mental Illness | 1852 W.grand Blvd, Detroit, MI 48208 | 2011-03-08 |
| 1356648034 | Shining Star Ll | Community Based Residential Treatment Facility, Mental Illness | 533 Mcdougall St, Detroit, MI 48207-3912 | 2011-02-16 |
| 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.