Active NPI
Taryn Reeve Koury, LLMSW
- Clinical Social Worker
- Pontiac, MI
National Provider Identifier
1053199083
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 6851117277
- Practice address
- 114 Orchard Lake Rd
Pontiac, MI 48341-2244 - Phone
- (248) 858-7766
- NPI assigned
- Sep 20, 2023
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 6851117277 | MI | Primary |
Addresses
Primary practice location
114 Orchard Lake Rd
Pontiac, MI 48341-2244
Mailing address
1923 Crooks Rd Apt 7
Royal Oak, MI 48073-4029
Phone (859) 893-6294
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6851117277 | MI | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1695168000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1695772800000",
"number": "1053199083",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1923 CROOKS RD APT 7",
"city": "ROYAL OAK",
"state": "MI",
"postal_code": "480734029",
"telephone_number": "859-893-6294"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "114 ORCHARD LAKE RD",
"city": "PONTIAC",
"state": "MI",
"postal_code": "483412244",
"telephone_number": "248-858-7766"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOURY",
"first_name": "TARYN",
"middle_name": "REEVE",
"credential": "LLMSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-09-20",
"last_updated": "2023-09-27",
"certification_date": "2023-09-27",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MI",
"license": "6851117277",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pontiac, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.