Individual provider Active NPI

Jaime Cordell, LLMSW

  • Clinical Social Worker
  • Lathrup Village, MI
National Provider Identifier
1124402664
Registry record updated Dec 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801108059 Issued in MI
Practice address
28211 Southfield Rd # 456
Lathrup Village, MI 48076-7047
Phone
(734) 780-4724
NPI assigned
Jul 15, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 28, 2022

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 6801108059 MI Primary

Addresses

Primary practice location

28211 Southfield Rd # 456
Lathrup Village, MI 48076-7047

Mailing address

28211 Southfield Rd # 456
Lathrup Village, MI 48076-7047

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

NPI Registry JSON

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

{
    "created_epoch": "1436918400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672185600000",
    "number": "1124402664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28211 SOUTHFIELD RD # 456",
            "city": "LATHRUP VILLAGE",
            "state": "MI",
            "postal_code": "480767047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28211 SOUTHFIELD RD # 456",
            "city": "LATHRUP VILLAGE",
            "state": "MI",
            "postal_code": "480767047",
            "telephone_number": "734-780-4724"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORDELL",
        "first_name": "JAIME",
        "credential": "LLMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-07-15",
        "last_updated": "2022-12-28",
        "certification_date": "2022-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801108059",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lathrup Village, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2022; 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.