Individual provider Active NPI

Jaice Colie Rowe III

  • Clinical Social Worker
  • Detroit, MI
National Provider Identifier
1063754612
Registry record updated Oct 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
12007 Linwood St
Detroit, MI 48206-1107
Phone
(313) 867-1090
Fax
(313) 867-0706
NPI assigned
Mar 21, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 14, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X
Clinical Social Worker 1041C0700X Primary

Addresses

Primary practice location

12007 Linwood St
Detroit, MI 48206-1107

Mailing address

4209 Pasadena St
Detroit, MI 48238-2656
Phone (270) 901-9524

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

NPI Registry JSON

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

{
    "created_epoch": "1363824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728864000000",
    "number": "1063754612",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4209 PASADENA ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482382656",
            "telephone_number": "270-901-9524",
            "fax_number": "313-867-0706"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12007 LINWOOD ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482061107",
            "telephone_number": "313-867-1090",
            "fax_number": "313-867-0706"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROWE",
        "first_name": "JAICE",
        "middle_name": "COLIE",
        "name_suffix": "III",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-03-21",
        "last_updated": "2024-10-14",
        "certification_date": "2024-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2024; 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.