LORETTA BANTOM


Address: 79 W Alexandrine St, Detroit, MI 48201-2015
Phone: 3138315535

LORETTA BANTOM (NPI# 1013448059) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1013448059
Entity Type Individual
Full Name LORETTA BANTOM
Practice Address 79 W Alexandrine St
Detroit
MI 48201-2015
Practice Telephone 3138315535
Practice Fax Number 3138312608
Mailing Telephone 3138315535
Mailing Fax Number 3138312608
Enumeration Date 2017-03-22
Last Update Date 2017-03-22
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 101YP2500X Counselor
Specialization: Professional 		6401015420 MI Behavioral Health & Social Service Providers

Office Location

Street Address 79 W ALEXANDRINE ST
City DETROIT
State MI
Zip Code 48201-2015

Providers in the same location

NPI Name Taxonomy Address Enumeration
1801846985 James Patrick Stenger Dentist 79 W Alexandrine St, 3rd Floor, Detroit, MI 48201-2015 2006-05-11
1518572809 Holly Paige Lawson Social Worker 79 W Alexandrine St, Detroit, MI 48201-2015 2020-09-13
1013522416 Sadie Berthiaume Case Manager/Care Coordinator 79 W Alexandrine St, Detroit, MI 48201-2015 2020-09-11
1720604028 Tasneem Mahmoud Abdelhamid Community Health Worker 79 W Alexandrine St, Detroit, MI 48201-2015 2020-06-23
1295358943 Jordan Michelle Nosis Student in an Organized Health Care Education/Training Program 79 W Alexandrine St, Detroit, MI 48201-2015 2020-05-28
1861032070 Joyce Witherspoon Case Manager/Care Coordinator 79 W Alexandrine St, Detroit, MI 48201-2015 2020-01-15
1770123176 Tyanna Elizabeth Jamison Peer Specialist 79 W Alexandrine St, Detroit, MI 48201-2015 2020-01-14
1518507565 Tia Mitchell Social Worker 79 W Alexandrine St, Detroit, MI 48201-2015 2020-01-07
1154960342 Kristin Marie Kunes Social Worker 79 W Alexandrine St, Detroit, MI 48201-2015 2020-01-05
1629615836 Stephanie Warren Dental Hygienist 79 W Alexandrine St, Detroit, MI 48201-2015 2019-12-06
Find all providers in the same location

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1659989838 Saima Sharif Student in an Organized Health Care Education/Training Program 4201 St Antoine St 9c-uhc Detroit Education & Research, Detroit, MI 48201 2020-07-14
1609494384 Praveen Kumar Boddu Student in an Organized Health Care Education/Training Program 3901,beaubien, Ste 3t72, Children's Hospital, Detroit, MI 48201 2020-07-09
1730707720 Amr Hassan Abdelghaffar Omar Pediatrics 3901 Beaubien St Room 3t72, Children's Hospital of Michigan, Detroit, MI 48201 2020-07-07
1700400694 Hassan Imtiaz Student in an Organized Health Care Education/Training Program 4201 St. Antoine 8c-uhc, Detroit Medical Center, Detroit, MI 48201 2020-06-05
1598389074 Alaa Awad Elkarim Student in an Organized Health Care Education/Training Program 3901 Beaubien St. 3t72, Detroit, MI 48201 2020-06-01
1891319299 Jeongyeon Hwang Student in an Organized Health Care Education/Training Program 4201 St Antoine Street University Health Center - 8c, Detroit, MI 48201 2020-06-01
1477176576 Jaudat Fatima Masood Student in an Organized Health Care Education/Training Program 4201 St Antoine Street, University Health Center - 8c, Detroit, MI 48201 2020-05-22
1205459419 Amit Kumar Dahiya Student in an Organized Health Care Education/Training Program 11201 St. Antoine, Room 2e Uhc, Detroit, MI 48201 2020-05-21
1851914188 Asra Nausheen Shaik Student in an Organized Health Care Education/Training Program 4201 St. Antoine St, Room 2e-uhc, Detroit, MI 48201 2020-05-21
1568085751 Camille Olechowski Student in an Organized Health Care Education/Training Program 3901 Chrysler Dr. Detroit Medical Center, Room 5-a 538.1, Detroit, MI 48201 2020-05-21
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Taxonomy Information

Taxonomy Code 101YP2500X
Grouping Behavioral Health & Social Service Providers
Classification Counselor
Specialization Professional

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1285244731 Better Days Counseling, Pllc Counselor 13501 Schaefer Hwy, Detroit, MI 48227-3538 2020-08-08
1174144281 Jasmine Noble Counselor 1535 Franklin St Apt 201, Detroit, MI 48207-4056 2020-04-29
1306473145 Julie Weatherhead Counselor 1624 Estates Dr, Detroit, MI 48206-2814 2020-03-23
1972134591 Tanya Bankston Counselor 4221 Moran St, Detroit, MI 48207-1705 2020-02-01
1871124768 Andrew Todd Henderson Counselor 1 Detroit Metro Airport, Detroit, MI 48242-1004 2020-01-29
1922561059 Odis Bellinger Counselor 440 Burroughs St Ste 149, Detroit, MI 48202-3429 2019-04-06
1245799469 Zipporah K Bolar Sr. Counselor 2900 Conner St Bldg A, Detroit, MI 48215-2407 2019-03-18
1215493549 Sammie Edwards Counselor 15734 Sussex St, Detroit, MI 48227 2019-02-12
1942764329 Crystal Jean Oliver Counselor 13770 Mecca St., Detroit, MI 48227-3025 2019-01-30
1922577246 Sheila Marie Cheeks Counselor 1600 Pingree St, Detroit, MI 48206-2436 2018-11-15
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Competitor

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City DETROIT
Zip Code 48201

Improve Information

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Dataset Information

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.

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