Traci A Doran, LMSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6801118756 Issued in MI

Practice address

10936 Old State Road
Johannesburg, MI 49751

Phone

(734) 755-3228

NPI assigned

Oct 13, 2021

Last updated

Oct 23, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Grow Healthcare Group PA

  • Mental Health Counselor
  • Miami, FL
  • NPI 1245845932

  Clinical, MI

  Medicare reassignment NPD
• Ta Therapeutic Services, LLC

  dba Traci A Doran

  • Mental Health Counselor
  • Glennie, MI
  • NPI 1598587966
  NPD Authorized official
• F&H Behavioral Health, PC

  • Addiction (Substance Use Disorder) Counselor
  • Lansing, MI
  • NPI 1841843182
  Medicare reassignment
• Balanced Restoration Services, LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Brighton, MI
  • NPI 1801404272
  NPD (past)

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

{
    "created_epoch": "1634083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729641600000",
    "number": "1023770393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 196",
            "city": "LUZERNE",
            "state": "MI",
            "postal_code": "486360196",
            "telephone_number": "734-755-3228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10936 OLD STATE ROAD",
            "city": "JOHANNESBURG",
            "state": "MI",
            "postal_code": "49751",
            "telephone_number": "734-755-3228"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DORAN",
        "first_name": "TRACI",
        "middle_name": "A",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-10-13",
        "last_updated": "2024-10-23",
        "certification_date": "2024-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801118756",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Evan Steven Gravedoni, PA-C
• Samantha Johnson-Klein
• Sara L McMichael
• Laura Rea, LPC
• Jillian Ross, LMSW

• Clinical Social Worker in Johannesburg, MI
• Providers in Johannesburg, MI by specialty
• Clinical Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.