Individual provider Active NPI

Thomas Arthur Klos II, LMSW

  • Social Worker
  • Ann Arbor, MI
National Provider Identifier
1093264541
Registry record updated May 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
6801118481 Issued in MI
Practice address
110 N 4TH Ave
Ann Arbor, MI 48104-5503
Phone
(734) 292-5542
Fax
(734) 222-6825
NPI assigned
Sep 26, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 14, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 6801118481 MI Primary

Addresses

Primary practice location

110 N 4TH Ave
Ann Arbor, MI 48104-5503

Mailing address

555 Towner St
Ypsilanti, MI 48198-5723
Phone (734) 292-5542

Other practice location 1

8623 N Wayne Rd
Suite 220
Westland, MI 48185-1137
Phone (734) 742-0605 ext. 173

Other practice location 2

555 Towner St
Ypsilanti, MI 48198
Phone (734) 544-3000

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
6801118481MIMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
County of Washtenaw CurrentSince Aug 8, 2021 Accepting new patients
County of Washtenaw PastSince Aug 8, 2021 Accepting new patients

Locations

110 N 4th Ave
Ann Arbor, MI 48104
Phone (734) 222-3750

555 Towner St
Ypsilanti, MI 48198
Phone (734) 544-3000

Organizations & group practices 2

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": "1474848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715644800000",
    "number": "1093264541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "555 TOWNER ST",
            "city": "YPSILANTI",
            "state": "MI",
            "postal_code": "481985723",
            "telephone_number": "734-292-5542"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 N 4TH AVE",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481045503",
            "telephone_number": "734-292-5542",
            "fax_number": "734-222-6825"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8623 N Wayne Rd",
            "address_2": "Suite 220",
            "address_purpose": "LOCATION",
            "city": "Westland",
            "state": "MI",
            "postal_code": "481851137",
            "country_code": "US",
            "telephone_number": "734-742-0605 x173",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "555 Towner St",
            "address_purpose": "LOCATION",
            "city": "Ypsilanti",
            "state": "MI",
            "postal_code": "48198",
            "country_code": "US",
            "telephone_number": "734-544-3000",
            "fax_number": "734-544-5718",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KLOS",
        "first_name": "THOMAS",
        "middle_name": "ARTHUR",
        "name_suffix": "II",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-09-26",
        "last_updated": "2024-05-14",
        "certification_date": "2024-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MI",
            "license": "6801118481",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ann Arbor, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2024; 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.