Charles Sonny Phipps Sr., LMSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6801094562 Issued in MI

Practice address

882 Oakman Blvd
Detroit, MI 48238-3710

Phone

(313) 961-7990

Fax

(313) 961-5120

NPI assigned

Feb 21, 2009

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1235174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473292800000",
    "number": "1083854707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16204 MOUNT VERNON ST",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480753108",
            "telephone_number": "313-920-1011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "882 OAKMAN BLVD",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482383710",
            "telephone_number": "313-961-7990",
            "fax_number": "313-961-5120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHIPPS",
        "first_name": "CHARLES",
        "middle_name": "SONNY",
        "name_prefix": "Mr.",
        "name_suffix": "Sr.",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-02-21",
        "last_updated": "2016-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801094562",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Traci Blalock Phillips, B.S. M.S. DMIN.
• Destiny Philson, LMSW
• Keri Philson
• Cassandra Marie Phipps, LLP, LLPC
• Chalisa Sharise-Renee Phipps
• Phlebotomy Nerds Mobile Labs
• Phoenix Arising Therapeutic Services
• Phoenix Interventions PLLC
• Phoenix Medical & Associates
• Phoenix Transformative Counseling Services

• Clinical Social Worker in Detroit, MI
• Providers in Detroit, MI by specialty
• Clinical Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2016; 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.