Active NPI
Doris Monica Geldres, MSW
- Social Worker
- Ypsilanti, MI
National Provider Identifier
1063773091
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 6801074099
- Practice address
- 5508 Michael Dr
Ypsilanti, MI 48197-6781 - Phone
- (734) 546-3366
- NPI assigned
- Jun 6, 2012
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 6801074099 | MI | |
| Social Worker | 104100000X | 6801074099 | MI | Primary |
Addresses
Primary practice location
5508 Michael Dr
Ypsilanti, MI 48197-6781
Mailing address
5508 Michael Dr
Ypsilanti, MI 48197-6781
Phone (734) 546-3366
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Social Worker
- Education
- Other, 1994
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1700 Waterman St
Detroit, MI 48209-2022
Phone (313) 841-8900
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Southwest Counseling Solutions | Clinical | Current | Accepting new patients |
Locations
5716 Michigan Ave
Detroit, MI 48210
Phone (313) 554-1095
1700 Waterman St
Detroit, MI 48209
Phone (313) 841-8900
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 and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1338940800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1663027200000",
"number": "1063773091",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5508 MICHAEL DR",
"city": "YPSILANTI",
"state": "MI",
"postal_code": "481976781",
"telephone_number": "734-546-3366"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5508 MICHAEL DR",
"city": "YPSILANTI",
"state": "MI",
"postal_code": "481976781",
"telephone_number": "734-546-3366"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GELDRES",
"first_name": "DORIS",
"middle_name": "MONICA",
"name_prefix": "Ms.",
"credential": "MSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-06-06",
"last_updated": "2022-09-13",
"certification_date": "2022-09-13",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MI",
"license": "6801074099",
"primary": false
},
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "MI",
"license": "6801074099",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Ypsilanti, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.