Individual provider Active NPI

Pamela Hopkins

  • Clinical Social Worker
  • Detroit, MI
National Provider Identifier
1104296169
Registry record updated Oct 3, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801072475 Issued in MI
Practice address
1500 E State Fair
Detroit, MI 48203-1258
Phone
(313) 790-3522
Fax
(947) 282-8999
NPI assigned
Oct 3, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 3, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 6801072475 MI Primary

Addresses

Primary practice location

1500 E State Fair
Detroit, MI 48203-1258

Mailing address

19115 Silvercrest St
Southfield, MI 48075-5813
Phone (248) 354-3788

Other identifiers 1

IdentifierTypeStateIssuer
1184011769OtherMIMEDICARE NPI

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)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
True Agape Adult Program PastSince Nov 4, 2015 Accepting new patients

Organizations & group practices 1

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": "1443830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1443830400000",
    "number": "1104296169",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19115 SILVERCREST ST",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480755813",
            "telephone_number": "248-354-3788",
            "fax_number": "248-354-5396"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 E STATE FAIR",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482031258",
            "telephone_number": "313-790-3522",
            "fax_number": "947-282-8999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOPKINS",
        "first_name": "PAMELA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-10-03",
        "last_updated": "2015-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801072475",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE NPI",
            "identifier": "1184011769",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2015; 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.