Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Loretta Bantom

Individual provider Professional Counselor · NPI 1013448059

Loretta Bantom is a Professional Counselor in Detroit, Michigan. Licensed in Michigan. Registered with an NPI since 2017.

Licensed in
MI
In the registry since
2017

Practice location Address checks out

79 W Alexandrine St
Detroit, MI 48201-2015
Phone: (313) 831-5535
Fax: (313) 831-2608
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Professional Counselor (primary) Taxonomy 101YP2500X · Licence 6401015420 (MI)

Record details

NPI number1013448059
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedMarch 22, 2017
Last updated in NPPESMarch 22, 2017
Mailing address79 W Alexandrine St, Detroit, MI 48201-2015

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