DR. KIMBERLY ELYSE (NPI# 1730320342) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1730320342 |
| Entity Type | Individual |
| Full Name | DR. KIMBERLY ELYSE |
| Credential | PH.D. |
| Practice Address |
12305 Dexter Ave Detroit MI 48206-1015 |
| Practice Telephone | 3133971306 |
| Practice Fax Number | 3133976010 |
| Mailing Telephone | 3133971306 |
| Mailing Fax Number | 3133976010 |
| Enumeration Date | 2009-03-11 |
| Last Update Date | 2009-03-11 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YP1600X |
Counselor Specialization: Pastoral |
Behavioral Health & Social Service Providers |
| Street Address |
12305 DEXTER AVE |
| City | DETROIT |
| State | MI |
| Zip Code | 48206-1015 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932322591 | Harold Edward Bradley Sr. | Counselor | 12305 Dexter Ave, Detroit, MI 48206-1015 | 2007-04-11 |
| 1518236116 | Kenneth Deon Blue | Substance Abuse Rehabilitation Facility | 12305 Dexter Ave, Detroit, MI 48206-1015 | 2011-12-28 |
| 1043503105 | Denise Mcnair | Substance Abuse Rehabilitation Facility | 12305 Dexter Ave, Detroit, MI 48206-1015 | 2011-05-24 |
| 1245464023 | William L. Taylor Jr. | Counselor | 12305 Dexter Ave, Detroit, MI 48206-1015 | 2009-05-08 |
| 1396986907 | William David Robinson Jr. | Counselor | 12305 Dexter Ave, Detroit, MI 48206-1015 | 2009-03-11 |
| 1740421361 | Bertha Collins-robinson | Counselor | 12305 Dexter Ave, Detroit, MI 48206-1015 | 2009-03-11 |
| 1851531156 | Get Back Up, Inc. | Substance Abuse Rehabilitation Facility | 12305 Dexter Ave, Detroit, MI 48206-1015 | 2009-02-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861962094 | Reid Talley | Counselor | 12010 Elmhurst, Detroit, MI 48206 | 2018-11-30 |
| 1306330246 | Harper's Care Club, LLC | Home Health | 1732 W Bethune St Apt 4, Detroit, MI 48206 | 2018-06-14 |
| 1700210440 | Tender Loving Care Assisted Living | Custodial Care Facility | 2250 W.euclid, Detroit, MI 48206 | 2013-08-29 |
| 1063560761 | Platinum Care Pharmacy Inc. | Pharmacy | 8500 14th Street, Detroit, MI 48206 | 2007-01-08 |
| 1619067527 | Young-sims Clinic PC | Family Medicine | 9150 Linwood, Detroit, MI 48206 | 2006-10-13 |
| 1093811200 | Grace W Patterson | Family Medicine | 9150 Linwood Ave, Detroit, MI 48206 | 2006-09-15 |
| 1164437992 | Rosa Park Medical Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 8665 Rosa Parks Boulavard, Detroit, MI 48206 | 2006-07-30 |
| 1336495696 | Ephraim I Onwuegbuchu | Pharmacist | 8500 14th Street, Detroit, MI 48206 | 2012-07-24 |
| 1962647552 | Jabez Recovery Management Services, Inc | Substance Abuse Rehabilitation Facility | 2755 Collingwood St, Detroit, MI 48206 | 2008-12-10 |
| 1033215918 | Robert Nmn Sims | Family Medicine | 9150 Linwood Ave, Detroit, MI 48206 | 2006-09-16 |
| Find all providers in zip 48206 | ||||
| Taxonomy Code | 101YP1600X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Pastoral |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760935381 | Lerrlyn Nelson | Counselor | 17101 Albion St, Detroit, MI 48234-3808 | 2016-08-01 |
| 1467906784 | Traci Blalock Phillips | Counselor | 1121 E Mcnichols Rd, Detroit, MI 48203-2857 | 2016-08-04 |
| 1356763874 | Karla Mitchell | Counselor | 18930 Greenfield Rd, Detroit, MI 48235-2976 | 2014-01-17 |
| 1508003781 | Felice Yvonne Adediran | Counselor | 4874 Lakewood St, Detroit, MI 48215-2105 | 2009-01-09 |
| 1679675532 | Keith Lamont Dangerfield | Counselor | 4646 John R St, Detroit, MI 48201-1916 | 2006-09-02 |
| 1386746261 | James Arthur Lewis | Counselor | 4646 John R St, Detroit, MI 48201-1916 | 2006-09-02 |
| 1841392008 | Michael L. Carr | Counselor | 4646 John R St, Detroit, MI 48201-1916 | 2006-09-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851868582 | Community Veterans Services Inc | Counselor | 163 Tennyson, Highland Park, MI 48203 | 2018-10-31 |
| 1215429212 | Debra Deanes | Counselor | 30233 Southfiels Rd, 203, Southfield, MI 48076 | 2018-06-05 |
| 1629589171 | Crystal Hudson | Counselor | 32e, 1200 N Telegraph Rd, Pontiac, MI 48341 | 2017-10-23 |
| 1144688235 | David Ray Taylor | Counselor | 8299 Silver Ct, Lambertville, MI 48144-8623 | 2016-02-03 |
| 1487079943 | Lowell Gisel | Counselor | 1705 S Saginaw Rd, Midland, MI 48640-5633 | 2014-02-20 |
| 1316362932 | Keith Lohman | Counselor | 6276 N Riverview Dr, Kalamazoo, MI 49004-9601 | 2014-02-19 |
| 1780029264 | Breaking The Links | Counselor | 630 Schultz St, Sparta, Mi, Sparta, MI 49345-9426 | 2013-05-09 |
| 1013283027 | Melinie Lynn Cappello | Counselor | 276 S Maple St, Zeeland, MI 49464-1914 | 2012-03-24 |
| 1790057693 | Ricky Joe Phillips | Counselor | 4346 Terrace Ln Se, Kentwood, MI 49512-5602 | 2012-02-07 |
| 1295054302 | Linda Lou Millek | Counselor | 18575 32nd St, Gobles, MI 49055 | 2010-05-28 |
| Find all providers with the same taxonomy | ||||
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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.