NPIMap

Organization Active NPI

Ennis Center for Children, Inc

  • Clinical Social Worker
  • Pontiac, MI
National Provider Identifier
1104244953
Registry record updated Mar 30, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801091820 Issued in MI
Legal business name
ENNIS CENTER FOR CHILDREN, INC
Practice address
91 S Telegraph Rd
Pontiac, MI 48341-1580
Phone
(248) 334-2715
NPI assigned
Mar 30, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2014

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

Authorized official

Name
Mr. Linton T. Matthews Jr., LMSWNPI 1598178097
Title
Social Worker
Phone
(313) 220-4760

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X 6801091820 MI Primary

Addresses

Primary practice location

91 S Telegraph Rd
Pontiac, MI 48341-1580

Mailing address

8752 W Outer Dr
Detroit, MI 48219-3589
Phone (313) 220-4760

National Provider Directory

National Provider Directory
Tax ID family
Ennis Center for Children Inc4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1396137600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1396137600000",
    "number": "1104244953",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8752 W OUTER DR",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482193589",
            "telephone_number": "313-220-4760"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "91 S TELEGRAPH RD",
            "city": "PONTIAC",
            "state": "MI",
            "postal_code": "483411580",
            "telephone_number": "248-334-2715"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ENNIS CENTER FOR CHILDREN, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-03-30",
        "last_updated": "2014-03-30",
        "status": "A",
        "authorized_official_last_name": "MATTHEWS",
        "authorized_official_first_name": "LINTON",
        "authorized_official_middle_name": "T.",
        "authorized_official_title_or_position": "SOCIAL WORKER",
        "authorized_official_telephone_number": "313-220-4760",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "LMSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801091820",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pontiac, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2014; 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.