Ms Kissie Shanta Washington, is a
Respite Care - Respite Care, Intellectual And/or Developmental Disabilities, Child based in Detroit, Michigan. Ms Kissie Shanta Washington is licensed to practice in Michigan (license number ) and her current practice location is
15476 Archdale St, Detroit, Michigan. She can be reached at her office (for appointments etc.) via phone at
(248) 249-3497.
NPI number for Ms Kissie Shanta Washington is 1306294707 and her current mailing address is 15476 Archdale St, Detroit, Michigan. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1306294707.
Healthcare Provider's Profile
| Full Name | Ms Kissie Shanta Washington |
|---|
| Gender | Female |
|---|
| Speciality | Respite Care - Respite Care, Intellectual And/or Developmental Disabilities, Child |
|---|
| Location | 15476 Archdale St, Detroit, Michigan |
|---|
| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
|---|
NPI Data:
- NPI Number: 1306294707
- Provider Enumeration Date: 05/26/2016
- Last Update Date: 12/28/2025
Medical Identifiers
Medical identifiers for Ms Kissie Shanta Washington such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1306294707 | NPI | - | NPPES |
| 821167995 | Medicaid | MI | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 101YM0800X | Counselor - Mental Health | (Michigan) | Secondary |
| 385HR2060X | Respite Care - Respite Care, Intellectual And/or Developmental Disabilities, Child | (Ohio) | Secondary |
| 247200000X | Technician, Other | (Michigan) | Secondary |
| 385HR2060X | Respite Care - Respite Care, Intellectual And/or Developmental Disabilities, Child | (Michigan) | Primary |
| 385HR2065X | Respite Care - Respite Care, Physical Disabilities, Child | (Ohio) | Secondary |
| 385HR2055X | Respite Care - Respite Care, Mental Illness, Child | (Ohio) | Secondary |
| 385HR2065X | Respite Care - Respite Care, Physical Disabilities, Child | (Michigan) | Secondary |
| 385HR2055X | Respite Care - Respite Care, Mental Illness, Child | (Michigan) | Secondary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Ms Kissie Shanta Washington is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Ms Kissie Shanta Washington,
15476 Archdale St,
Detroit, MI 48227-1506
Ph: (248) 249-3497 | Ms Kissie Shanta Washington,
15476 Archdale St,
Detroit, MI 48227-1506
Ph: (248) 249-3497 |
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