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LORETTA BANTOM
NPI 1013448059
Counselor - Professional in Detroit, MI

Active since March 22, 2017
79 W ALEXANDRINE ST, DETROIT, MI 48201(313) 831-5535(313) 831-2608 Get Directions Write a Review

NPPES record last updated: March 22, 2017. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Loretta Bantom NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

LORETTA BANTOM (NPI 1013448059) is an individual professional provider in Detroit, Michigan, licensed in Michigan (6401015420) and active in the NPI registry since March 2017.

NPPES Registry Identity

NPI1013448059
Entity TypeIndividualFemale
Primary Taxonomy101YP2500X
Provider Legal NameLORETTA BANTOM
Location Address79 W ALEXANDRINE STDetroit, MI 48201-2015
Mailing Address79 W Alexandrine StDetroit, MI 48201-2015 · (313) 831-5535 · Fax (313) 831-2608
Phone(313) 831-5535
Fax(313) 831-2608
Sole ProprietorNo
Enumeration DateMarch 22, 2017
✔ NPI 1013448059 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · ProfessionalBehavioral Health & Social Service Providers
Taxonomy Code101YP2500X
License✔ Licensed in MI · 6401015420
79 W ALEXANDRINE ST, Detroit, MI 48201
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Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

LEAH WELTON MSW
Social Worker (Clinical)
79 W ALEXANDRINE ST
DETROIT, MI 48201
Wayne County (313) 831-5535
MS. EMILY FRANCES TROYER LPC
Counselor (Professional)
79 W ALEXANDRINE ST
DETROIT, MI 48201
Wayne County (313) 831-5535
ROJET MORROW LLMSW,CMHP
Social Worker (Clinical)
79 W ALEXANDRINE ST
DETROIT, MI 48201
Wayne County (313) 831-5535
ANGELA ORR
Behavior Technician
79 W ALEXANDRINE ST
DETROIT, MI 48201
Wayne County (313) 831-5535
LINDA HENDERSON
Specialist
79 W ALEXANDRINE ST
DETROIT, MI 48201
Wayne County (313) 831-5535
CIARA COX
Behavior Technician
79 W ALEXANDRINE ST
DETROIT, MI 48201
Wayne County (313) 831-2008
THE CHILDREN'S CENTER OF WAYNE CO., INC.
Psychologist (Clinical Child & Adolescent)
79 W ALEXANDRINE ST
DETROIT, MI 48201
Wayne County (313) 262-0951
BRIANA PARKER LLMSW
Case Manager/Care Coordinator
79 W ALEXANDRINE ST
DETROIT, MI 48201
Wayne County (313) 831-2608

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Loretta Bantom's NPI number?

The NPI number for Loretta Bantom is 1013448059. It was assigned to this individual provider in the NPPES registry on March 22, 2017.

Where is Loretta Bantom located?

Loretta Bantom practices at 79 W Alexandrine St, Detroit, MI 48201. The listed phone number is (313) 831-5535.

What is Loretta Bantom's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.

When was this NPI record last updated?

The NPPES record for Loretta Bantom was last updated on March 22, 2017. NPI Profile syncs with the weekly NPPES data releases published by CMS.