Active NPI
Tammoda M Jolly, LBSW
- Social Worker
- Livonia, MI
National Provider Identifier
1083808372
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 6802081324
- Practice address
- 16836 Newburgh Rd
Livonia, MI 48154-1600 - Phone
- (734) 464-4220
- NPI assigned
- Aug 30, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 6802081324 | MI | Primary |
Addresses
Primary practice location
16836 Newburgh Rd
Livonia, MI 48154-1600
Mailing address
3800 Woodward Ave
Ste 600
Detroit, MI 48201-2061
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
| License | State | Type | Specialty |
|---|---|---|---|
| 6802081324 | MI | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1188432000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1188432000000",
"number": "1083808372",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3800 WOODWARD AVE",
"address_2": "STE 600",
"city": "DETROIT",
"state": "MI",
"postal_code": "482012061"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "16836 NEWBURGH RD",
"city": "LIVONIA",
"state": "MI",
"postal_code": "481541600",
"telephone_number": "734-464-4220"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOLLY",
"first_name": "TAMMODA",
"middle_name": "M",
"credential": "LBSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-08-30",
"last_updated": "2007-08-30",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "MI",
"license": "6802081324",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Livonia, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.