Organization Active NPI

TLC Soulutions, Inc.

  • Social Worker
  • Waterford, MI
National Provider Identifier
1053855916
Registry record updated Feb 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
Legal business name
TLC SOULUTIONS, INC.
Practice address
2691 Sylvan Shores Dr
Waterford, MI 48328-3936
Phone
(248) 842-0068
NPI assigned
Dec 12, 2016
Last updated
Feb 28, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2025

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

Authorized official

Name
Nancy Mae Nicholson, LMSWNPI 1104266543
Title
LMSW
Phone
(248) 842-0068

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X NU Primary
In Home Supportive Care Agency 253Z00000X 6801088993 MI

Addresses

Primary practice location

2691 Sylvan Shores Dr
Waterford, MI 48328-3936

Mailing address

2691 Sylvan Shores Dr
Waterford, MI 48328-3936
Phone (248) 842-0068

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190409001980 MI Part B Supplier - Clinic/Group Practice 6709127327 Receives reassigned benefits from 1 practitioner
Practice locations: Waterford, MI

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1481500800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1740700800000",
    "number": "1053855916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2691 SYLVAN SHORES DR",
            "city": "WATERFORD",
            "state": "MI",
            "postal_code": "483283936",
            "telephone_number": "248-842-0068"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2691 SYLVAN SHORES DR",
            "city": "WATERFORD",
            "state": "MI",
            "postal_code": "483283936",
            "telephone_number": "248-842-0068"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TLC SOULUTIONS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-12-12",
        "last_updated": "2025-02-28",
        "certification_date": "2025-02-28",
        "status": "A",
        "authorized_official_last_name": "NICHOLSON",
        "authorized_official_first_name": "NANCY",
        "authorized_official_middle_name": "MAE",
        "authorized_official_title_or_position": "LMSW",
        "authorized_official_telephone_number": "248-842-0068",
        "authorized_official_credential": "LMSW"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "MI",
            "license": "6801088993",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waterford, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.