Caryette Fenner, LBSW, QIDP

Primary specialty

Social WorkerTaxonomy code 104100000X

License

6802081466 Issued in MI

Practice address

2140 E Ellsworth Rd
Ann Arbor, MI 48108-2552

Phone

(734) 222-3433

Fax

(734) 222-3461

NPI assigned

Jun 29, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1435536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1435536000000",
    "number": "1083096879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "555 TOWNER ST",
            "address_2": "P.O. BOX 915",
            "city": "YPSILANTI",
            "state": "MI",
            "postal_code": "481985752",
            "telephone_number": "734-544-3000",
            "fax_number": "734-544-6732"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2140 E ELLSWORTH RD",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481082552",
            "telephone_number": "734-222-3433",
            "fax_number": "734-222-3461"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FENNER",
        "first_name": "CARYETTE",
        "credential": "LBSW, QIDP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-29",
        "last_updated": "2015-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MI",
            "license": "6802081466",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF MICHIGAN DEPARTMENT OF LICENSING AND REGULATORY AFFAIRS",
            "identifier": "6802081466",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• A Mark Fendrick, MD
• Meikun Feng, CRNA
• Ning Feng
• Yang Feng
• Jordan Lee Fennema, MD
• Dee Ellen Fenner, MD
• Diane Lynn Fenske, LMSW
• Dana Feraco, D.O.
• Benjamin David Ferguson, MD, PHD
• Diane Leslie Ferguson, NP

• Social Worker in Ann Arbor, MI
• Providers in Ann Arbor, MI by specialty
• Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2015; 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.