MEDICARE: LASHELL TONETTE WEST LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	6451023271	MI

General Provider Information

NPI Number	:	1447978853
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LASHELL TONETTE WEST LLC

Provider Business Mailing Address
First Line	:	22080 RIVER RIDGE TRL
Second Line	:
City	:	FARMINGTON HILLS
State	:	MI
Zip	:	48335-4666
Country	:	US
Telephone Number	:	313-721-8022
Fax Number	:

Provider Business Practice Location Address
First Line	:	22080 RIVER RIDGE TRL
Second Line	:
City	:	FARMINGTON HILLS
State	:	MI
Zip	:	48335-4666
Country	:	US
Telephone Number	:	313-721-8022
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/22/2022
Last Update Date	:	02/10/2026

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