Individual provider Active NPI

Kay Daugherty Farrell, MSW, LMSW

  • Clinical Social Worker
  • Detroit, MI
National Provider Identifier
1073942363
Registry record updated Nov 6, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801005340 Issued in MI
Practice address
1025 E Forest Ave
BLDG B, Room 451
Detroit, MI 48207-1024
Phone
(313) 833-0362
Fax
(313) 237-9212
NPI assigned
Nov 6, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 6, 2013

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 6801005340 MI Primary

Addresses

Primary practice location

1025 E Forest Ave
BLDG B, Room 451
Detroit, MI 48207-1024

Mailing address

1025 E Forest Ave
BLDG B, Room 451
Detroit, MI 48207-1024
Phone (313) 833-0362

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

State licenses

LicenseStateTypeSpecialty
6801005340MIMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1383696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1383696000000",
    "number": "1073942363",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1025 E FOREST AVE",
            "address_2": "BLDG B, ROOM 451",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482071024",
            "telephone_number": "313-833-0362",
            "fax_number": "313-237-9212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1025 E FOREST AVE",
            "address_2": "BLDG B, ROOM 451",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482071024",
            "telephone_number": "313-833-0362",
            "fax_number": "313-237-9212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FARRELL",
        "first_name": "KAY",
        "middle_name": "DAUGHERTY",
        "credential": "MSW, LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-11-06",
        "last_updated": "2013-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801005340",
            "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 Nov 6, 2013; 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.