Joseph Anthony-Porto Radell-Reilly, LMSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6801096169 Issued in MI

Practice address

15700 W 10 Mile Rd Ste 106
Southfield, MI 48075-2100

Phone

(989) 225-4111

Fax

(248) 575-4555

NPI assigned

Nov 4, 2013

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Joe Reilly Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1383523200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555459200000",
    "number": "1114356813",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3017 ELSTEAD ST",
            "city": "AUBURN HILLS",
            "state": "MI",
            "postal_code": "483262312",
            "telephone_number": "734-846-2848"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15700 W 10 MILE RD STE 106",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480752100",
            "telephone_number": "989-225-4111",
            "fax_number": "248-575-4555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RADELL-REILLY",
        "first_name": "JOSEPH",
        "middle_name": "ANTHONY-PORTO",
        "name_prefix": "Mr.",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-11-04",
        "last_updated": "2019-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801096169",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JOE",
            "last_name": "REILLY",
            "credential": "LMSW",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Clinical Social Worker in Southfield, MI
• Providers in Southfield, 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 Apr 17, 2019; 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.