Individual provider Active NPI

Tonya Marie Nelson-Williams, LMSW

  • Clinical Social Worker
  • Detroit, MI
National Provider Identifier
1053758375
Registry record updated Mar 27, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801069572 Issued in MI
Practice address
2226 Hyde Park Rd
Detroit, MI 48207-4964
Phone
(313) 282-9682
NPI assigned
May 28, 2013
Reactivated
Mar 27, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 27, 2018

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 6801069572 MI Primary

Addresses

Primary practice location

2226 Hyde Park Rd
Detroit, MI 48207-4964

Mailing address

2226 Hyde Park Rd
Detroit, MI 48207-4964
Phone (313) 282-9682

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20171205001189 MI Practitioner - Clinical Social Worker 7012274756 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6801069572MIMDClinical Social Worker

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1369699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1522108800000",
    "number": "1053758375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2226 HYDE PARK RD",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482074964",
            "telephone_number": "313-282-9682"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2226 HYDE PARK RD",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482074964",
            "telephone_number": "313-282-9682"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON-WILLIAMS",
        "first_name": "TONYA",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-05-28",
        "last_updated": "2018-03-27",
        "deactivation_date": "2018-01-29",
        "reactivation_date": "2018-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801069572",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

Verify at the official NPI Registry.