NPIMap

Organization Active NPI

Henry Ford Health Providence Hospital

Doing business as Henry Ford Providence Hospital

  • Clinical Social Worker
  • Southfield, MI
National Provider Identifier
1144285107
Registry record updated Jul 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
HENRY FORD HEALTH PROVIDENCE HOSPITAL
Doing business as
Henry Ford Providence Hospital
Practice address
16001 W 9 Mile Rd
Southfield, MI 48075-4818
Phone
(248) 849-3000
Fax
(248) 849-2244
NPI assigned
Apr 20, 2006
Last updated
Jul 16, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2026

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

Authorized official

Name
Kimberly Cebalt
Title
Director
Phone
(313) 874-6764

Specialties & licenses 7

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X NU
Professional Counselor 101YP2500X NU
Psychologist 103T00000X NU
Clinical Psychologist 103TC0700X NU
Social Worker 104100000X NU
Clinical Social Worker 1041C0700X NU Primary
General Practice Physician 208D00000X NU

Addresses

Primary practice location

16001 W 9 Mile Rd
Southfield, MI 48075-4818

Mailing address

PO Box 670884
Detroit, MI 48267-0884
Phone (800) 999-5829

Other identifiers 1

IdentifierTypeStateIssuer
800F316780OtherMIMI BLUE CROSS GROUPPIN#

Other names 2

  • Henry Ford Providence Hospital Doing business as
  • PH Social Workers /Providence Hosptial and Medical Centers Inc Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040316001258 MI Part B Supplier - Clinic/Group Practice 6103738703 Receives reassigned benefits from 8 practitioners
Practice locations: Southfield, MI; Novi, MI; Livonia, MI

Other NPIs with the same Medicare PAC ID 6

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
PH Family Practice32 organizations share this tax ID, including this one

Other organizations with this tax ID 31

Organizations that report the same tax identification number in the National Provider Directory.

View all 31

Locations

3168 Solutions Ctr
Chicago, IL 60677

26750 Providence Pkwy
Novi, MI 48374
Phone (248) 465-4782

47601 Grand River Ave
Ste C131
Novi, MI 48374
Phone (248) 380-4335

Practitioners & affiliated clinicians

Practitioners 12

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1145491200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1784160000000",
    "number": "1144285107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 670884",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482670884",
            "telephone_number": "800-999-5829",
            "fax_number": "248-641-4840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16001 W 9 MILE RD",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480754818",
            "telephone_number": "248-849-3000",
            "fax_number": "248-849-2244"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HENRY FORD HEALTH PROVIDENCE HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-20",
        "last_updated": "2026-07-16",
        "certification_date": "2026-07-16",
        "status": "A",
        "authorized_official_last_name": "CEBALT",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "313-874-6764"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MI BLUE CROSS GROUPPIN#",
            "identifier": "800F316780",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Henry Ford Providence Hospital",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "PH Social Workers /Providence Hosptial and Medical Centers Inc",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Southfield, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.