Carol Ann Bobak, LMSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6801108996 Issued in MI

Practice address

4646 John R St
Detroit, MI 48201-1916

Phone

(313) 576-3686

Fax

(313) 576-1446

NPI assigned

Feb 10, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1612915200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612915200000",
    "number": "1124610100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5941 HUNTINGTON DR",
            "city": "YPSILANTI",
            "state": "MI",
            "postal_code": "481977192",
            "telephone_number": "313-576-3686",
            "fax_number": "313-576-1446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4646 JOHN R ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482011916",
            "telephone_number": "313-576-3686",
            "fax_number": "313-576-1446"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOBAK",
        "first_name": "CAROL",
        "middle_name": "ANN",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-02-10",
        "last_updated": "2021-02-10",
        "certification_date": "2021-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801108996",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hashem Boalbanat
• Boar Logistics LLC
• Sarah Board, OTR/L
• Jessica Lynn Boardman, LMSW
• Bob & Renia Complete Home Services LLC
• Michael Duane Bobbitt Jr., LPC
• Melinda Mary Bobco, PHYSICIAN ASSISTANT
• Irina Bobeica, NP
• Haley Boccomino
• Cory Bockenhauer, MD

• Clinical Social Worker in Detroit, MI
• Providers in Detroit, 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 Feb 10, 2021; 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.