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1205206927 NPI number — KEVIN ANTHONY ALLEN MA, LLPC

NPI Number: 1205206927
Health Care Provider/Practitioner: KEVIN ANTHONY ALLEN MA, LLPC

Information about “1205206927” NPI (KEVIN ANTHONY ALLEN MA, LLPC) exists in 1205206927 in HTML format HTML  |  1205206927 in plain Text format TXT  |  1205206927 in PDF (Portable Document Format) PDF  |  1205206927 in an XML format XML  formats.

NPI Number : 1205206927 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1205206927",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "ALLEN",
    "FirstName": "KEVIN",
    "MiddleName": "ANTHONY",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "MA, LLPC",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "1040 W BRISTOL RD",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "FLINT",
    "MailingAddressStateName": "MI",
    "MailingAddressPostalCode": "48507-5516",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "810-931-5737",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "1040 W BRISTOL RD",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "FLINT",
    "PracticeLocationAddressStateName": "MI",
    "PracticeLocationAddressPostalCode": "48507-5516",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "810-931-5737",
    "PracticeLocationAddressFaxNumber": "816-254-9243",
    "EnumerationDate": "10/07/2015",
    "LastUpdateDate": "03/25/2025",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "M",
    "Gender": "Male",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "101Y00000X",
          "TaxonomyName": "Counselor",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "101Y00000X",
          "TaxonomyName": "Counselor",
          "LicenseNumber": "6451014313",
          "LicenseNumberStateCode": "MI",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "101YP2500X",
          "TaxonomyName": "Professional Counselor",
          "LicenseNumber": null,
          "LicenseNumberStateCode": "MO",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "101YM0800X",
          "TaxonomyName": "Mental Health Counselor",
          "LicenseNumber": "6451014313",
          "LicenseNumberStateCode": "MI",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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