Kourtenay Caldwell, LLBSW

Primary specialty

Case Manager/Care CoordinatorTaxonomy code 171M00000X

License

L2551540 Issued in MI

Practice address

14799 Dix Toledo Rd
Southgate, MI 48195-2507

Phone

(734) 324-8326

Fax

(734) 324-8327

NPI assigned

Nov 8, 2013

Sex

Female

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1383868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1383868800000",
    "number": "1053740100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9930 SUSSEX ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482272010",
            "telephone_number": "313-778-8727"
        },
        {
            "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": "CALDWELL",
        "first_name": "KOURTENAY",
        "credential": "LLBSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-11-08",
        "last_updated": "2013-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "MI",
            "license": "L2551540",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Case Manager/Care Coordinator in Southgate, MI
• Providers in Southgate, MI by specialty
• Case Manager/Care Coordinator in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2013; 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.