Individual provider Active NPI

Peggy Woehrlen, LMSW, LMFT

  • Social Worker
  • Southfield, MI
National Provider Identifier
1093814824
Registry record updated Aug 16, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
6801005123 Issued in MI
Practice address
30231 Canterbury Dr
Southfield, MI 48076-1201
Phone
(248) 701-4977
Fax
(248) 723-9469
NPI assigned
Sep 21, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 16, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 6801005123 MI Primary
Marriage & Family Therapist 106H00000X 4101005894 MI

Addresses

Primary practice location

30231 Canterbury Dr
Southfield, MI 48076-1201

Mailing address

18090 Mack Ave
Grosse Pointe, MI 48230-6251
Phone (248) 701-4977

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080610000607 MI Practitioner - Clinical Social Worker 8022910371

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4101005894MIMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Peggy Woehrlen Acsw LMSW LMFT PC Social Worker CurrentSince Jul 3, 2012 Accepting new patients
Downriver Mental Health Clinic PC Past Accepting new patients
Macomb Family Services, Inc Past Accepting new patients
Macomb Family Services, Inc. PastSince Jan 1, 1995 Accepting new patients

Locations

18090 Mack Ave
Grosse Pointe, MI 48230
Phone (248) 701-4977

23100 Jefferson Ave
Saint Clair Shores, MI 48080
Phone (586) 335-2006

Interoperability endpoints

  • FHIR API: https://api.qualifacts.org/api/fhir/macombfamily/r4/

Organizations & group practices 4

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": "1158796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1281916800000",
    "number": "1093814824",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18090 MACK AVE",
            "city": "GROSSE POINTE",
            "state": "MI",
            "postal_code": "482306251",
            "telephone_number": "248-701-4977",
            "fax_number": "313-642-1998"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30231 CANTERBURY DR",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480761201",
            "telephone_number": "248-701-4977",
            "fax_number": "248-723-9469"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOEHRLEN",
        "first_name": "PEGGY",
        "credential": "LMSW, LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-21",
        "last_updated": "2010-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MI",
            "license": "6801005123",
            "primary": true
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MI",
            "license": "4101005894",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southfield, MI

Sources for this page

Verify at the official NPI Registry.