Individual provider Active NPI

Cheryl J Davidge, LMSW

  • Clinical Social Worker
  • Royal Oak, MI
National Provider Identifier
1073670113
Registry record updated Nov 5, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801012826 Issued in MI
Practice address
424 W 5TH St
Suite 210
Royal Oak, MI 48067-2545
Phone
(248) 953-3034
NPI assigned
Jan 1, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 5, 2007

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 6801012826 MI Primary

Addresses

Primary practice location

424 W 5TH St
Suite 210
Royal Oak, MI 48067-2545

Mailing address

1311 Marywood Dr
Royal Oak, MI 48067-4324
Phone (248) 541-3303

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
I20050324000316 MI Practitioner - Clinical Social Worker 9931155793 Practice locations: Royal Oak, MI

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1974
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

424 W 5TH St
Suite 210
Royal Oak, MI 48067-2573
Phone (248) 953-3034

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6801012826MIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Henry Ford Health System Past Accepting new patients

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": "1167609600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1194220800000",
    "number": "1073670113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1311 MARYWOOD DR",
            "city": "ROYAL OAK",
            "state": "MI",
            "postal_code": "480674324",
            "telephone_number": "248-541-3303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "424 W 5TH ST",
            "address_2": "SUITE 210",
            "city": "ROYAL OAK",
            "state": "MI",
            "postal_code": "480672545",
            "telephone_number": "248-953-3034"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIDGE",
        "first_name": "CHERYL",
        "middle_name": "J",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-01",
        "last_updated": "2007-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801012826",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Royal Oak, MI

Sources for this page

Verify at the official NPI Registry.