Healthcare Provider Details

I. General information

NPI: 1962223461
Provider Name (Legal Business Name): LANITA CHANEL HUNT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/18/2024
Last Update Date: 07/23/2025
Certification Date: 07/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1030 BURLINGTON LN
FRANKFORT KY
40601-8444
US

IV. Provider business mailing address

882 OAKMAN BLVD
DETROIT MI
48238-3710
US

V. Phone/Fax

Practice location:
  • Phone: 313-974-4746
  • Fax:
Mailing address:
  • Phone: 313-961-4890
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: