Individual provider Active NPI

Isabel Ruth Ryzenga, LLMSW

  • Social Worker
  • Waterford, MI
National Provider Identifier
1134948326
Registry record updated Oct 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
6851117410 Issued in MI
Practice address
3901 Highland Rd Ste C
Waterford, MI 48328-2162
Phone
(248) 721-9335
NPI assigned
Oct 7, 2024
Last updated
Oct 7, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 7, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 6851117410 MI Primary

Addresses

Primary practice location

3901 Highland Rd Ste C
Waterford, MI 48328-2162

Mailing address

23761 Easterling Ave
Hazel Park, MI 48030-1434
Phone (616) 594-8524

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

State licenses

LicenseStateTypeSpecialty
6851117410MIMDSocial Worker

NPI Registry JSON

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

{
    "created_epoch": "1728259200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728259200000",
    "number": "1134948326",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23761 EASTERLING AVE",
            "city": "HAZEL PARK",
            "state": "MI",
            "postal_code": "480301434",
            "telephone_number": "616-594-8524"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3901 HIGHLAND RD STE C",
            "city": "WATERFORD",
            "state": "MI",
            "postal_code": "483282162",
            "telephone_number": "248-721-9335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RYZENGA",
        "first_name": "ISABEL",
        "middle_name": "RUTH",
        "credential": "LLMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-10-07",
        "last_updated": "2024-10-07",
        "certification_date": "2024-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MI",
            "license": "6851117410",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waterford, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2024; 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.