Individual provider Active NPI

Kenneth Love II

  • Clinical Social Worker
  • Southgate, MI
National Provider Identifier
1003366261
Registry record updated Oct 11, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
14799 Dix Toledo Rd
Southgate, MI 48195-2507
Phone
(734) 324-8326
Fax
(734) 324-8327
NPI assigned
Oct 11, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 11, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X MI Primary

Addresses

Primary practice location

14799 Dix Toledo Rd
Southgate, MI 48195-2507

Mailing address

11326 Goddard CT
Taylor, MI 48180-6218
Phone (734) 324-8326

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1476144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476144000000",
    "number": "1003366261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11326 GODDARD CT",
            "city": "TAYLOR",
            "state": "MI",
            "postal_code": "481806218",
            "telephone_number": "734-324-8326",
            "fax_number": "734-324-8327"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14799 DIX TOLEDO RD",
            "city": "SOUTHGATE",
            "state": "MI",
            "postal_code": "481952507",
            "telephone_number": "734-324-8326",
            "fax_number": "734-324-8327"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOVE",
        "first_name": "KENNETH",
        "name_prefix": "Mr.",
        "name_suffix": "II",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-10-11",
        "last_updated": "2016-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southgate, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.