Individual provider Active NPI

Teresa Josephine Kaminski

  • Clinical Social Worker
  • Niles, MI
National Provider Identifier
1134867286
Registry record updated May 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
1225 S 11TH St
Niles, MI 49120-3408
Phone
(269) 684-7741
NPI assigned
May 26, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 26, 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 Primary

Addresses

Primary practice location

1225 S 11TH St
Niles, MI 49120-3408

Mailing address

299 E Lasalle Ave Apt 304B
South Bend, IN 46617-3703
Phone (616) 916-5978

Other identifiers 1

IdentifierTypeStateIssuer
1114256526MedicaidMI

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)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1653523200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653523200000",
    "number": "1134867286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "299 E LASALLE AVE APT 304B",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466173703",
            "telephone_number": "616-916-5978"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1225 S 11TH ST",
            "city": "NILES",
            "state": "MI",
            "postal_code": "491203408",
            "telephone_number": "269-684-7741"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAMINSKI",
        "first_name": "TERESA",
        "middle_name": "JOSEPHINE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-05-26",
        "last_updated": "2022-05-26",
        "certification_date": "2022-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1114256526",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Niles, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 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.