Multidimensions Care Management

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6801034096 Issued in MI

Legal business name

MULTIDIMENSIONS CARE MANAGEMENT

Practice address

17555 James Couzens Fwy
2 West
Detroit, MI 48235-2657

Phone

(313) 864-2987

Fax

(313) 864-2142

NPI assigned

Dec 3, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Larry Willis Colston, LMSW

Title

Ceo

Phone

(313) 864-2987

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1165104000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1124196415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17555 JAMES COUZENS FWY",
            "address_2": "2-WEST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482352657",
            "telephone_number": "313-864-2987",
            "fax_number": "313-864-2142"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17555 JAMES COUZENS FWY",
            "address_2": "2 WEST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482352657",
            "telephone_number": "313-864-2987",
            "fax_number": "313-864-2142"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MULTIDIMENSIONS CARE MANAGEMENT",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-03",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "COLSTON",
        "authorized_official_first_name": "LARRY",
        "authorized_official_middle_name": "WILLIS",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "313-864-2987",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LMSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801034096",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUE OPTIONS PROVIDER #",
            "identifier": "096642",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.